- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,174.90 / $9,549.93 / $19,952.62
| Facility | | $1,174.90 | $9,549.93 | $19,952.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $60.26 / $141.25 / $562.34
| Professional | | $60.26 | $141.25 | $562.34 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,511.89 / $4,570.88 / $12,882.50
| Facility | | $2,511.89 | $4,570.88 | $12,882.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $66.07 / $100.00 / $269.15
| Professional | | $66.07 | $100.00 | $269.15 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $85.11 / $4,466.84 / $8,912.51
| Facility | | $85.11 | $4,466.84 | $8,912.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $72.44 / $144.54 / $323.59
| Professional | | $72.44 | $144.54 | $323.59 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $134.90 / $134.90 / $158.49
| Facility | | $134.90 | $134.90 | $158.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $69.18 / $147.91 / $363.08
| Professional | | $69.18 | $147.91 | $363.08 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $37.15 / $69.18 / $208.93
| Professional | | $37.15 | $69.18 | $208.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $61.66 / $147.91 / $288.40
| Professional | | $61.66 | $147.91 | $288.40 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $54.95 / $56.23 / $3,890.45
| Facility | | $54.95 | $56.23 | $3,890.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,023.29 / $1,202.26 / $1,202.26
| Professional | | $1,023.29 | $1,202.26 | $1,202.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $120.23 / $120.23 / $199.53
| Professional | | $120.23 | $120.23 | $199.53 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $66.07 / $125.89 / $251.19
| Facility | | $66.07 | $125.89 | $251.19 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $67.61 / $147.91 / $331.13
| Professional | | $67.61 | $147.91 | $331.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $204.17 / $204.17 / $467.74
| Professional | | $204.17 | $204.17 | $467.74 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $38.02 / $60.26 / $162.18
| Professional | | $38.02 | $60.26 | $162.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,187.76 / $4,265.80 / $9,549.93
| Facility | | $2,187.76 | $4,265.80 | $9,549.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $57.54 / $123.03 / $302.00
| Professional | | $57.54 | $123.03 | $302.00 |