- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $181.97 / $524.81 / $17,782.79
| Facility | | $181.97 | $524.81 | $17,782.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $97.72 / $134.90 / $323.59
| Professional | | $97.72 | $134.90 | $323.59 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $512.86 / $660.69 / $1,348.96
| Facility | | $512.86 | $660.69 | $1,348.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $144.54 / $208.93 / $295.12
| Professional | | $144.54 | $208.93 | $295.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $117.49 / $117.49 / $117.49
| Facility | | $117.49 | $117.49 | $117.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $144.54 / $223.87 / $346.74
| Professional | | $144.54 | $223.87 | $346.74 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $117.49 / $218.78 / $323.59
| Facility | | $117.49 | $218.78 | $323.59 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $117.49 / $213.80 / $302.00
| Professional | | $117.49 | $213.80 | $302.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $60.26
| Professional | | $32.36 | $33.11 | $60.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $147.91 / $239.88 / $245.47
| Facility | | $147.91 | $239.88 | $245.47 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $165.96 / $165.96 / $169.82
| Facility | | $165.96 | $165.96 | $169.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $131.83 / $204.17 / $309.03
| Professional | | $131.83 | $204.17 | $309.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $457.09 / $691.83 / $1,348.96
| Facility | | $457.09 | $691.83 | $1,348.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $144.54 / $204.17 / $295.12
| Professional | | $144.54 | $204.17 | $295.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $229.09 / $870.96 / $1,995.26
| Facility | | $229.09 | $870.96 | $1,995.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $125.89 / $181.97 / $316.23
| Professional | | $125.89 | $181.97 | $316.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $89.13 / $141.25 / $181.97
| Professional | | $89.13 | $141.25 | $181.97 |