- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $346.74 / $794.33 / $18,620.87
| Facility | | $346.74 | $794.33 | $18,620.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $199.53 / $281.84 / $676.08
| Professional | | $199.53 | $281.84 | $676.08 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $501.19 / $501.19 / $501.19
| Professional | | $501.19 | $501.19 | $501.19 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,801.89 / $4,897.79 / $10,000.00
| Facility | | $3,801.89 | $4,897.79 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $302.00 / $446.68 / $691.83
| Professional | | $302.00 | $446.68 | $691.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,380.38 / $1,380.38 / $2,344.23
| Facility | | $1,380.38 | $1,380.38 | $2,344.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $269.15 / $489.78 / $776.25
| Professional | | $269.15 | $489.78 | $776.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $275.42 / $501.19 / $2,691.53
| Facility | | $275.42 | $501.19 | $2,691.53 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $275.42 / $478.63 / $891.25
| Professional | | $275.42 | $478.63 | $891.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $95.50
| Professional | | $32.36 | $33.11 | $95.50 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $269.15 / $489.78 / $537.03
| Facility | | $269.15 | $489.78 | $537.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $380.19 / $380.19 / $380.19
| Facility | | $380.19 | $380.19 | $380.19 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $295.12 / $457.09 / $691.83
| Professional | | $295.12 | $457.09 | $691.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,548.13 / $5,011.87 / $10,000.00
| Facility | | $3,548.13 | $5,011.87 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $309.03 / $446.68 / $645.65
| Professional | | $309.03 | $446.68 | $645.65 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,698.24 / $6,606.93 / $11,748.98
| Facility | | $1,698.24 | $6,606.93 | $11,748.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $257.04 / $354.81 / $691.83
| Professional | | $257.04 | $354.81 | $691.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $208.93 / $309.03 / $398.11
| Professional | | $208.93 | $309.03 | $398.11 |