- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $676.08 / $676.08 / $676.08
| Facility | | $676.08 | $676.08 | $676.08 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $245.47 / $446.68 / $676.08
| Professional | | $245.47 | $446.68 | $676.08 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $47.86 / $1,479.11 / $1,905.46
| Facility | | $47.86 | $1,479.11 | $1,905.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $79.43 / $131.83 / $199.53
| Professional | | $79.43 | $131.83 | $199.53 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $134.90 / $151.36 / $186.21
| Professional | | $134.90 | $151.36 | $186.21 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $56.23 / $154.88 / $776.25
| Facility | | $56.23 | $154.88 | $776.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $95.50 / $363.08 / $831.76
| Professional | | $95.50 | $363.08 | $831.76 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.23 / $23.99 / $50.12
| Facility | | $1.23 | $23.99 | $50.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.93 / $26.92 / $60.26
| Professional | | $0.93 | $26.92 | $60.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $56.23 / $162.18 / $870.96
| Facility | | $56.23 | $162.18 | $870.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $117.49 / $2,238,721.14 / $2,398,832.92
| Professional | | $117.49 | $2,238,721.14 | $2,398,832.92 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $776.25 / $1,621.81 / $2,089.30
| Facility | | $776.25 | $1,621.81 | $2,089.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $125.89 / $147.91 / $199.53
| Professional | | $125.89 | $147.91 | $199.53 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,659.59 / $2,041.74 / $2,691.53
| Facility | | $1,659.59 | $2,041.74 | $2,691.53 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $93.33 / $537.03 / $1,445.44
| Professional | | $93.33 | $537.03 | $1,445.44 |