- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $245.47 / $389.05 / $575.44
| Facility | | $245.47 | $389.05 | $575.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $223.87 / $269.15 / $707.95
| Professional | | $223.87 | $269.15 | $707.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $218.78 / $288.40 / $724.44
| Professional | | $218.78 | $288.40 | $724.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $36.31 / $36.31 / $354.81
| Facility | | $36.31 | $36.31 | $354.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $36.31 / $354.81 / $389.05
| Professional | | $36.31 | $354.81 | $389.05 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $524.81 / $891.25 / $2,344.23
| Facility | | $524.81 | $891.25 | $2,344.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $208.93 / $467.74 / $1,122.02
| Professional | | $208.93 | $467.74 | $1,122.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $190.55 / $295.12 / $776.25
| Facility | | $190.55 | $295.12 | $776.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $257.04 / $354.81 / $537.03
| Professional | | $257.04 | $354.81 | $537.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $75.86 / $75.86 / $75.86
| Facility | | $75.86 | $75.86 | $75.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $91.20 / $302.00 / $457.09
| Professional | | $91.20 | $302.00 | $457.09 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $223.87 / $446.68 / $53,703.18
| Facility | | $223.87 | $446.68 | $53,703.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $323.59 / $380.19 / $416.87
| Professional | | $323.59 | $380.19 | $416.87 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $794.33 / $2,818.38 / $3,162.28
| Facility | | $794.33 | $2,818.38 | $3,162.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $213.80 / $323.59 / $812.83
| Professional | | $213.80 | $323.59 | $812.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $75.86 / $199.53 / $562.34
| Facility | | $75.86 | $199.53 | $562.34 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $199.53 / $309.03 / $575.44
| Professional | | $199.53 | $309.03 | $575.44 |