- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $363.08 / $870.96 / $7,943.28
| Facility | | $363.08 | $870.96 | $7,943.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $173.78 / $309.03 / $724.44
| Professional | | $173.78 | $309.03 | $724.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $602.56 / $602.56 / $602.56
| Facility | | $602.56 | $602.56 | $602.56 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $239.88 / $416.87 / $831.76
| Professional | | $239.88 | $416.87 | $831.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $295.12 / $436.52 / $812.83
| Professional | | $295.12 | $436.52 | $812.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $186.21 / $389.05 / $776.25
| Facility | | $186.21 | $389.05 | $776.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $275.42 / $489.78 / $758.58
| Professional | | $275.42 | $489.78 | $758.58 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $371.54 / $602.56 / $645.65
| Facility | | $371.54 | $602.56 | $645.65 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $186.21 / $389.05 / $776.25
| Facility | | $186.21 | $389.05 | $776.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $79.43 / $407.38 / $758.58
| Professional | | $79.43 | $407.38 | $758.58 |
- 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
- $331.13 / $512.86 / $891.25
| Professional | | $331.13 | $512.86 | $891.25 |
- 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
- $263.03 / $446.68 / $776.25
| Professional | | $263.03 | $446.68 | $776.25 |