- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $281.84 / $3,019.95 / $17,782.79
| Facility | | $281.84 | $3,019.95 | $17,782.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $218.78 / $1,096.48 / $2,398.83
| Professional | | $218.78 | $1,096.48 | $2,398.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $218.78 / $218.78 / $363.08
| Professional | | $218.78 | $218.78 | $363.08 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $316.23 / $660.69 / $3,090.30
| Professional | | $316.23 | $660.69 | $3,090.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $302.00 / $645.65 / $3,548.13
| Professional | | $302.00 | $645.65 | $3,548.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $331.13 / $616.60 / $3,162.28
| Facility | | $331.13 | $616.60 | $3,162.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $346.74 / $645.65 / $3,235.94
| Professional | | $346.74 | $645.65 | $3,235.94 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $56.23
| Professional | | $32.36 | $33.11 | $56.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,412.54 / $2,344.23 / $2,570.40
| Facility | | $1,412.54 | $2,344.23 | $2,570.40 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,737.80 / $1,778.28 / $1,778.28
| Facility | | $1,737.80 | $1,778.28 | $1,778.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $281.84 / $1,737.80 / $3,162.28
| Professional | | $281.84 | $1,737.80 | $3,162.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $316.23 / $660.69 / $3,090.30
| Professional | | $316.23 | $660.69 | $3,090.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $190.55 / $912.01 / $5,754.40
| Facility | | $190.55 | $912.01 | $5,754.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $295.12 / $1,258.93 / $3,162.28
| Professional | | $295.12 | $1,258.93 | $3,162.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $194.98 / $371.54 / $1,819.70
| Professional | | $194.98 | $371.54 | $1,819.70 |