- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $645.65 / $1,202.26 / $13,182.57
| Facility | | $645.65 | $1,202.26 | $13,182.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $316.23 / $501.19 / $1,122.02
| Professional | | $316.23 | $501.19 | $1,122.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $691.83 / $691.83 / $691.83
| Facility | | $691.83 | $691.83 | $691.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $407.38 / $707.95 / $1,230.27
| Professional | | $407.38 | $707.95 | $1,230.27 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $537.03 / $794.33 / $1,202.26
| Professional | | $537.03 | $794.33 | $1,202.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $338.84 / $645.65 / $1,122.02
| Facility | | $338.84 | $645.65 | $1,122.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $478.63 / $741.31 / $1,122.02
| Professional | | $478.63 | $741.31 | $1,122.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $562.34 / $912.01 / $954.99
| Facility | | $562.34 | $912.01 | $954.99 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $346.74 / $630.96 / $1,122.02
| Facility | | $346.74 | $630.96 | $1,122.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $79.43 / $691.83 / $1,122.02
| Professional | | $79.43 | $691.83 | $1,122.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,495.41 / $7,413.10 / $9,120.11
| Facility | | $5,495.41 | $7,413.10 | $9,120.11 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $8,128.31 / $10,964.78 / $13,803.84
| Facility | 50 | $8,128.31 | $10,964.78 | $13,803.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $588.84 / $891.25 / $1,318.26
| Professional | | $588.84 | $891.25 | $1,318.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,951.21 / $9,120.11 / $12,022.64
| Facility | | $2,951.21 | $9,120.11 | $12,022.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $436.52 / $724.44 / $1,202.26
| Professional | | $436.52 | $724.44 | $1,202.26 |