- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $77.62 / $588.84 / $912.01
| Facility | | $77.62 | $588.84 | $912.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $93.33 / $380.19
| Professional | | $32.36 | $93.33 | $380.19 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,584.89 / $3,090.30 / $5,754.40
| Facility | | $1,584.89 | $3,090.30 | $5,754.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $47.86 / $114.82 / $316.23
| Professional | | $47.86 | $114.82 | $316.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $162.18 / $162.18 / $162.18
| Professional | | $162.18 | $162.18 | $162.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $204.17 / $239.88 / $380.19
| Facility | | $204.17 | $239.88 | $380.19 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $47.86 / $104.71 / $281.84
| Professional | | $47.86 | $104.71 | $281.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $30.20 / $158.49 / $3,801.89
| Facility | | $30.20 | $158.49 | $3,801.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $63.10 / $100.00 / $223.87
| Professional | | $63.10 | $100.00 | $223.87 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $31.62 / $489.78 / $1,778.28
| Facility | | $31.62 | $489.78 | $1,778.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $77.62 / $147.91 / $436.52
| Professional | | $77.62 | $147.91 | $436.52 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $112.20
| Professional | | $32.36 | $33.11 | $112.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $87.10 / $891.25 / $2,344.23
| Facility | | $87.10 | $891.25 | $2,344.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $97.72 / $141.25 / $263.03
| Professional | | $97.72 | $141.25 | $263.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $51.29 / $112.20 / $269.15
| Professional | | $51.29 | $112.20 | $269.15 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $199.53 / $1,318.26 / $1,318.26
| Facility | | $199.53 | $1,318.26 | $1,318.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $44.67 / $223.87 / $660.69
| Professional | | $44.67 | $223.87 | $660.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $154.88 / $154.88 / $398.11
| Professional | | $154.88 | $154.88 | $398.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $131.83 / $245.47 / $457.09
| Professional | | $131.83 | $245.47 | $457.09 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $977.24 / $1,584.89 / $2,187.76
| Facility | | $977.24 | $1,584.89 | $2,187.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $43.65 / $107.15 / $269.15
| Professional | | $43.65 | $107.15 | $269.15 |