- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $173.78 / $2,137.96 / $6,456.54
| Facility | | $173.78 | $2,137.96 | $6,456.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $79.43 / $162.18 / $389.05
| Professional | | $79.43 | $162.18 | $389.05 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $38.90 / $114.82 / $186.21
| Professional | | $38.90 | $114.82 | $186.21 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,951.21 / $4,073.80 / $33,113.11
| Facility | | $2,951.21 | $4,073.80 | $33,113.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $85.11 / $85.11 / $109.65
| Professional | | $85.11 | $85.11 | $109.65 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,801.89 / $4,466.84 / $57,543.99
| Facility | | $3,801.89 | $4,466.84 | $57,543.99 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $117.49 / $173.78 / $204.17
| Professional | | $117.49 | $173.78 | $204.17 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $141.25 / $1,000.00 / $1,905.46
| Facility | | $141.25 | $1,000.00 | $1,905.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $85.11 / $162.18 / $302.00
| Professional | | $85.11 | $162.18 | $302.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $158.49 / $158.49 / $158.49
| Facility | | $158.49 | $158.49 | $158.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $177.83 / $245.47 / $354.81
| Professional | | $177.83 | $245.47 | $354.81 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $741.31 / $1,174.90 / $1,318.26
| Facility | | $741.31 | $1,174.90 | $1,318.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $100.00 / $186.21 / $323.59
| Professional | | $100.00 | $186.21 | $323.59 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,513.56 / $4,073.80 / $6,606.93
| Facility | | $1,513.56 | $4,073.80 | $6,606.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $83.18 / $89.13 / $154.88
| Professional | | $83.18 | $89.13 | $154.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,511.89 / $3,630.78 / $16,218.10
| Facility | | $2,511.89 | $3,630.78 | $16,218.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $85.11 / $85.11 / $109.65
| Professional | | $85.11 | $85.11 | $109.65 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $128.82 / $1,412.54 / $6,606.93
| Facility | | $128.82 | $1,412.54 | $6,606.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $83.18 / $173.78 / $407.38
| Professional | | $83.18 | $173.78 | $407.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $371.54 / $371.54 / $371.54
| Facility | | $371.54 | $371.54 | $371.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $251.19 / $323.59 / $371.54
| Professional | | $251.19 | $323.59 | $371.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $81.28 / $309.03 / $616.60
| Facility | | $81.28 | $309.03 | $616.60 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $79.43 / $169.82 / $309.03
| Professional | | $79.43 | $169.82 | $309.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $588.84 / $2,570.40 / $5,623.41
| Facility | | $588.84 | $2,570.40 | $5,623.41 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $77.62 / $151.36 / $295.12
| Professional | | $77.62 | $151.36 | $295.12 |