- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $398.11 / $3,090.30 / $7,762.47
| Facility | | $398.11 | $3,090.30 | $7,762.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $251.19 / $331.13 / $912.01
| Professional | | $251.19 | $331.13 | $912.01 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,630.27 / $4,786.30 / $9,549.93
| Facility | | $2,630.27 | $4,786.30 | $9,549.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $204.17 / $263.03 / $707.95
| Professional | | $204.17 | $263.03 | $707.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $407.38 / $407.38 / $4,073.80
| Facility | | $407.38 | $407.38 | $4,073.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $407.38 / $407.38 / $407.38
| Professional | | $407.38 | $407.38 | $407.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $34.67 / $4,365.16 / $53,703.18
| Facility | | $34.67 | $4,365.16 | $53,703.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $288.40 / $537.03 / $1,288.25
| Professional | | $288.40 | $537.03 | $1,288.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $302.00 / $575.44 / $1,000.00
| Facility | | $302.00 | $575.44 | $1,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $302.00 / $389.05 / $524.81
| Professional | | $302.00 | $389.05 | $524.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $251.19 / $676.08 / $1,023.29
| Professional | | $251.19 | $676.08 | $1,023.29 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,235.94 / $50,118.72 / $75,857.76
| Facility | | $3,235.94 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $338.84 / $398.11 / $616.60
| Professional | | $338.84 | $398.11 | $616.60 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,137.96 / $3,981.07 / $9,120.11
| Facility | | $2,137.96 | $3,981.07 | $9,120.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $269.15 / $416.87 / $870.96
| Professional | | $269.15 | $416.87 | $870.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $234.42 / $331.13 / $977.24
| Facility | | $234.42 | $331.13 | $977.24 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $234.42 / $616.60 / $1,023.29
| Professional | | $234.42 | $616.60 | $1,023.29 |