- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $83.18 / $2,089.30 / $7,413.10
| Facility | | $83.18 | $2,089.30 | $7,413.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $58.88 / $173.78 / $524.81
| Professional | | $58.88 | $173.78 | $524.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $208.93 / $218.78 / $223.87
| Professional | | $208.93 | $218.78 | $223.87 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,819.70 / $3,630.78 / $5,011.87
| Facility | | $1,819.70 | $3,630.78 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $144.54 / $173.78 / $398.11
| Professional | | $144.54 | $173.78 | $398.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $81.28 / $81.28 / $4,073.80
| Facility | | $81.28 | $81.28 | $4,073.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $81.28 / $81.28 / $331.13
| Professional | | $81.28 | $81.28 | $331.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $34.67 / $97.72 / $50,118.72
| Facility | | $34.67 | $97.72 | $50,118.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $63.10 / $204.17 / $616.60
| Professional | | $63.10 | $204.17 | $616.60 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $57.54 / $100.00 / $204.17
| Facility | | $57.54 | $100.00 | $204.17 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $251.19 / $371.54 / $524.81
| Professional | | $251.19 | $371.54 | $524.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $131.83 / $281.84 / $501.19
| Professional | | $131.83 | $281.84 | $501.19 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $123.03 / $1,023.29 / $1,698.24
| Facility | | $123.03 | $1,023.29 | $1,698.24 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $239.88 / $331.13 / $380.19
| Professional | | $239.88 | $331.13 | $380.19 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $63.10 / $50,118.72 / $75,857.76
| Facility | | $63.10 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $229.09 / $389.05 / $630.96
| Professional | | $229.09 | $389.05 | $630.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,348.96 / $2,511.89 / $4,897.79
| Facility | | $1,348.96 | $2,511.89 | $4,897.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $69.18 / $323.59 / $660.69
| Professional | | $69.18 | $323.59 | $660.69 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $46.77 / $66.07 / $208.93
| Facility | | $46.77 | $66.07 | $208.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $131.83 / $257.04 / $478.63
| Professional | | $131.83 | $257.04 | $478.63 |