- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $446.68 / $478.63 / $707.95
| Facility | | $446.68 | $478.63 | $707.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $446.68 / $575.44 / $707.95
| Professional | | $446.68 | $575.44 | $707.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $72.44 / $131.83 / $288.40
| Facility | | $72.44 | $131.83 | $288.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $52.48 / $54.95 / $61.66
| Professional | | $52.48 | $54.95 | $61.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $56.23 / $229.09 / $229.09
| Professional | | $56.23 | $229.09 | $229.09 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $776.25 / $776.25 / $776.25
| Facility | | $776.25 | $776.25 | $776.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $562.34 / $562.34 / $645.65
| Facility | | $562.34 | $562.34 | $645.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $66.07 / $602.56 / $602.56
| Professional | | $66.07 | $602.56 | $602.56 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,288.25 / $4,365.16 / $4,365.16
| Facility | | $1,288.25 | $4,365.16 | $4,365.16 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $77.62 / $446.68 / $1,023.29
| Facility | | $77.62 | $446.68 | $1,023.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $446.68 / $691.83 / $707.95
| Professional | | $446.68 | $691.83 | $707.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $69.18 / $93.33 / $933.25
| Professional | | $69.18 | $93.33 | $933.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $77.62 / $446.68 / $1,047.13
| Facility | | $77.62 | $446.68 | $1,047.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $109.65 / $602.56 / $602.56
| Professional | | $109.65 | $602.56 | $602.56 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $45.71 / $354.81 / $588.84
| Facility | | $45.71 | $354.81 | $588.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $363.08 / $478.63 / $912.01
| Professional | | $363.08 | $478.63 | $912.01 |