- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $48.98 / $117.49 / $165.96
| Facility | | $48.98 | $117.49 | $165.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $58.88 / $83.18 / $107.15
| Professional | | $58.88 | $83.18 | $107.15 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $147.91 / $147.91 / $295.12
| Facility | | $147.91 | $147.91 | $295.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $85.11 / $87.10 / $229.09
| Professional | | $85.11 | $87.10 | $229.09 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $112.20 / $120.23 / $120.23
| Facility | | $112.20 | $120.23 | $120.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $120.23 / $120.23 / $120.23
| Professional | | $120.23 | $120.23 | $120.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $100.00 / $100.00 / $53,703.18
| Facility | | $100.00 | $100.00 | $53,703.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $74.13 / $74.13 / $181.97
| Professional | | $74.13 | $74.13 | $181.97 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $147.91 / $245.47 / $562.34
| Facility | | $147.91 | $245.47 | $562.34 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $91.20 / $147.91 / $281.84
| Professional | | $91.20 | $147.91 | $281.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $56.23 / $56.23 / $58.88
| Facility | | $56.23 | $56.23 | $58.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $56.23 / $87.10 / $93.33
| Professional | | $56.23 | $87.10 | $93.33 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $120.23 / $50,118.72 / $75,857.76
| Facility | | $120.23 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $97.72 / $141.25 / $141.25
| Professional | | $97.72 | $141.25 | $141.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $60.26 / $83.18 / $416.87
| Facility | | $60.26 | $83.18 | $416.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $56.23 / $95.50 / $245.47
| Professional | | $56.23 | $95.50 | $245.47 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $56.23 / $83.18 / $87.10
| Facility | | $56.23 | $83.18 | $87.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $56.23 / $87.10 / $93.33
| Professional | | $56.23 | $87.10 | $93.33 |