- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $67.61 / $2,344.23 / $8,317.64
| Facility | | $67.61 | $2,344.23 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $36.31 / $51.29 / $138.04
| Professional | | $36.31 | $51.29 | $138.04 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $75.86 / $75.86 / $75.86
| Professional | | $75.86 | $75.86 | $75.86 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,011.87 / $8,511.38 / $77,624.71
| Facility | | $5,011.87 | $8,511.38 | $77,624.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $43.65 / $63.10 / $87.10
| Professional | | $43.65 | $63.10 | $87.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $41.69 / $57.54 / $87.10
| Professional | | $41.69 | $57.54 | $87.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $81.28 / $81.28 / $87.10
| Professional | | $81.28 | $81.28 | $87.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $46.77 / $66.07 / $97.72
| Professional | | $46.77 | $66.07 | $97.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $478.63 / $1,819.70 / $6,606.93
| Facility | | $478.63 | $1,819.70 | $6,606.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $36.31 / $52.48 / $100.00
| Professional | | $36.31 | $52.48 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $66.07 / $87.10 / $107.15
| Professional | | $66.07 | $87.10 | $107.15 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.77 / $46.77 / $436.52
| Facility | | $9.77 | $46.77 | $436.52 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $17.38 / $46.77 / $436.52
| Professional | | $17.38 | $46.77 | $436.52 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $162.18 / $630.96 / $4,466.84
| Facility | | $162.18 | $630.96 | $4,466.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $40.74 / $54.95 / $89.13
| Professional | | $40.74 | $54.95 | $89.13 |