- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $186.21 / $363.08 / $1,905.46
| Facility | | $186.21 | $363.08 | $1,905.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $169.82 / $239.88 / $467.74
| Professional | | $169.82 | $239.88 | $467.74 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,311.31 / $4,786.30 / $7,585.78
| Facility | | $3,311.31 | $4,786.30 | $7,585.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $213.80 / $426.58 / $1,000.00
| Professional | | $213.80 | $426.58 | $1,000.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $602.56 / $691.83 / $1,122.02
| Facility | | $602.56 | $691.83 | $1,122.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $229.09 / $489.78 / $831.76
| Professional | | $229.09 | $489.78 | $831.76 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $204.17 / $467.74 / $3,801.89
| Facility | | $204.17 | $467.74 | $3,801.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $380.19 / $489.78 / $676.08
| Professional | | $380.19 | $489.78 | $676.08 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $204.17 / $2,570.40 / $5,754.40
| Facility | | $204.17 | $2,570.40 | $5,754.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $218.78 / $398.11 / $1,148.15
| Professional | | $218.78 | $398.11 | $1,148.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $295.12
| Professional | | $32.36 | $33.11 | $295.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $346.74 / $3,890.45 / $4,570.88
| Facility | | $346.74 | $3,890.45 | $4,570.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $309.03 / $549.54 / $758.58
| Professional | | $309.03 | $549.54 | $758.58 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $245.47 / $501.19 / $741.31
| Professional | | $245.47 | $501.19 | $741.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,801.89 / $5,623.41 / $5,623.41
| Facility | | $3,801.89 | $5,623.41 | $5,623.41 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $239.88 / $645.65 / $2,344.23
| Professional | | $239.88 | $645.65 | $2,344.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $467.74 / $467.74 / $616.60
| Professional | | $467.74 | $467.74 | $616.60 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $446.68 / $851.14 / $1,096.48
| Professional | | $446.68 | $851.14 | $1,096.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,884.03 / $3,548.13 / $6,918.31
| Facility | | $2,884.03 | $3,548.13 | $6,918.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $181.97 / $338.84 / $891.25
| Professional | | $181.97 | $338.84 | $891.25 |