- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $380.19 / $676.08 / $758.58
| Facility | | $380.19 | $676.08 | $758.58 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $229.09 / $380.19 / $933.25
| Professional | | $229.09 | $380.19 | $933.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,754.23 / $3,890.45 / $7,762.47
| Facility | | $2,754.23 | $3,890.45 | $7,762.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $407.38 / $630.96 / $954.99
| Professional | | $407.38 | $630.96 | $954.99 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,698.24 / $3,630.78 / $6,606.93
| Facility | | $1,698.24 | $3,630.78 | $6,606.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $380.19 / $602.56 / $954.99
| Professional | | $380.19 | $602.56 | $954.99 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $489.78 / $758.58 / $5,888.44
| Facility | | $489.78 | $758.58 | $5,888.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $489.78 / $707.95 / $912.01
| Professional | | $489.78 | $707.95 | $912.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $33.11
| Professional | | $32.36 | $33.11 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $91.20 / $467.74 / $616.60
| Facility | | $91.20 | $467.74 | $616.60 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $69.18 / $100.00 / $588.84
| Professional | | $69.18 | $100.00 | $588.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $398.11 / $407.38 / $407.38
| Facility | | $398.11 | $407.38 | $407.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $398.11 / $616.60 / $812.83
| Professional | | $398.11 | $616.60 | $812.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $954.99 / $3,801.89 / $7,762.47
| Facility | | $954.99 | $3,801.89 | $7,762.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $407.38 / $630.96 / $933.25
| Professional | | $407.38 | $630.96 | $933.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,202.26 / $4,466.84 / $7,762.47
| Facility | | $1,202.26 | $4,466.84 | $7,762.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $223.87 / $309.03 / $812.83
| Professional | | $223.87 | $309.03 | $812.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $338.84 / $398.11 / $645.65
| Professional | | $338.84 | $398.11 | $645.65 |