- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $120.23 / $2,238.72 / $3,981.07
| Facility | | $120.23 | $2,238.72 | $3,981.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $100.00 / $147.91 / $457.09
| Professional | | $100.00 | $147.91 | $457.09 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $56.23 / $2,951.21 / $7,585.78
| Facility | | $56.23 | $2,951.21 | $7,585.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $114.82 / $194.98 / $512.86
| Professional | | $114.82 | $194.98 | $512.86 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $138.04 / $138.04 / $316.23
| Facility | | $138.04 | $138.04 | $316.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $134.90 / $363.08 / $549.54
| Professional | | $134.90 | $363.08 | $549.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $138.04 / $239.88 / $446.68
| Professional | | $138.04 | $239.88 | $446.68 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $66.07 / $138.04 / $3,311.31
| Facility | | $66.07 | $138.04 | $3,311.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $100.00 / $162.18 / $275.42
| Professional | | $100.00 | $162.18 | $275.42 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,041.74 / $4,265.80 / $9,772.37
| Facility | | $2,041.74 | $4,265.80 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $128.82 / $213.80 / $426.58
| Professional | | $128.82 | $213.80 | $426.58 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,949.84 / $1,949.84 / $1,949.84
| Facility | | $1,949.84 | $1,949.84 | $1,949.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $56.23 / $2,951.21 / $7,585.78
| Facility | | $56.23 | $2,951.21 | $7,585.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $114.82 / $194.98 / $512.86
| Professional | | $114.82 | $194.98 | $512.86 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,862.09 / $3,981.07 / $9,772.37
| Facility | | $1,862.09 | $3,981.07 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $125.89 / $213.80 / $457.09
| Professional | | $125.89 | $213.80 | $457.09 |