- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $234.42 / $4,466.84 / $18,620.87
| Facility | | $234.42 | $4,466.84 | $18,620.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $123.03 / $162.18 / $346.74
| Professional | | $123.03 | $162.18 | $346.74 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,090.30 / $4,365.16 / $8,709.64
| Facility | | $3,090.30 | $4,365.16 | $8,709.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $169.82 / $239.88 / $316.23
| Professional | | $169.82 | $239.88 | $316.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,000.00 / $1,000.00 / $1,000.00
| Facility | | $1,000.00 | $1,000.00 | $1,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $158.49 / $257.04 / $371.54
| Professional | | $158.49 | $257.04 | $371.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $169.82 / $295.12 / $4,466.84
| Facility | | $169.82 | $295.12 | $4,466.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $158.49 / $275.42 / $1,348.96
| Professional | | $158.49 | $275.42 | $1,348.96 |
- 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
- $204.17 / $245.47 / $263.03
| Facility | | $204.17 | $245.47 | $263.03 |
- 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
- $169.82 / $263.03 / $363.08
| Professional | | $169.82 | $263.03 | $363.08 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,951.21 / $4,466.84 / $8,709.64
| Facility | | $2,951.21 | $4,466.84 | $8,709.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $169.82 / $239.88 / $331.13
| Professional | | $169.82 | $239.88 | $331.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,096.48 / $5,128.61 / $9,332.54
| Facility | | $1,096.48 | $5,128.61 | $9,332.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $131.83 / $199.53 / $346.74
| Professional | | $131.83 | $199.53 | $346.74 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $120.23 / $151.36 / $229.09
| Professional | | $120.23 | $151.36 | $229.09 |