- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $52.48 / $309.03 / $537.03
| Facility | | $52.48 | $309.03 | $537.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $18.20 / $117.49
| Professional | | $5.01 | $18.20 | $117.49 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $64.57 / $407.38 / $3,388.44
| Facility | | $64.57 | $407.38 | $3,388.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $676.08 / $676.08 / $676.08
| Facility | | $676.08 | $676.08 | $676.08 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.68 / $40.74 / $107.15
| Facility | | $4.68 | $40.74 | $107.15 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $245.47 / $245.47 / $245.47
| Facility | | $245.47 | $245.47 | $245.47 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $52.48 / $281.84 / $478.63
| Facility | | $52.48 | $281.84 | $478.63 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $18.20 / $60,255.96
| Professional | | $5.01 | $18.20 | $60,255.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $30.20 / $30.20 / $30.20
| Professional | | $30.20 | $30.20 | $30.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.25 / $36.31 / $128.82
| Facility | | $5.25 | $36.31 | $128.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,398,832.92 / $2,398,832.92 / $2,398,832.92
| Professional | | $2,398,832.92 | $2,398,832.92 | $2,398,832.92 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.14 / $2.14 / $6.03
| Facility | | $2.14 | $2.14 | $6.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.25 / $30.20 / $120.23
| Professional | | $5.25 | $30.20 | $120.23 |