- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $128.82 / $1,096.48 / $13,803.84
| Facility | | $128.82 | $1,096.48 | $13,803.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $69.18 / $371.54 / $912.01
| Professional | | $69.18 | $371.54 | $912.01 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7,244.36 / $9,120.11 / $18,620.87
| Facility | | $7,244.36 | $9,120.11 | $18,620.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $114.82 / $223.87 / $954.99
| Professional | | $114.82 | $223.87 | $954.99 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $95.50 / $288.40 / $1,122.02
| Professional | | $95.50 | $288.40 | $1,122.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $109.65 / $436.52 / $1,288.25
| Facility | | $109.65 | $436.52 | $1,288.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $104.71 / $269.15 / $933.25
| Professional | | $104.71 | $269.15 | $933.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $43.65
| Professional | | $32.36 | $33.11 | $43.65 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $446.68 / $741.31 / $794.33
| Facility | | $446.68 | $741.31 | $794.33 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $575.44 / $602.56 / $602.56
| Facility | | $575.44 | $602.56 | $602.56 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $102.33 / $575.44 / $1,071.52
| Professional | | $102.33 | $575.44 | $1,071.52 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,309.57 / $9,549.93 / $18,620.87
| Facility | | $6,309.57 | $9,549.93 | $18,620.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $114.82 / $223.87 / $912.01
| Professional | | $114.82 | $223.87 | $912.01 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,311.31 / $12,022.64 / $20,417.38
| Facility | | $3,311.31 | $12,022.64 | $20,417.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $91.20 / $354.81 / $912.01
| Professional | | $91.20 | $354.81 | $912.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $66.07 / $125.89 / $588.84
| Professional | | $66.07 | $125.89 | $588.84 |