- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $309.03 / $309.03 / $17,782.79
| Facility | | $309.03 | $309.03 | $17,782.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $309.03 / $489.78 / $616.60
| Professional | | $309.03 | $489.78 | $616.60 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7,585.78 / $15,135.61 / $26,302.68
| Facility | | $7,585.78 | $15,135.61 | $26,302.68 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $512.86 / $1,023.29 / $2,818.38
| Professional | | $512.86 | $1,023.29 | $2,818.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11,481.54 / $11,481.54 / $11,481.54
| Facility | | $11,481.54 | $11,481.54 | $11,481.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $691.83 / $2,187.76 / $2,187.76
| Professional | | $691.83 | $2,187.76 | $2,187.76 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $309.03 / $489.78 / $776.25
| Facility | | $309.03 | $489.78 | $776.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $426.58 / $4,073.80 / $8,709.64
| Facility | | $426.58 | $4,073.80 | $8,709.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $562.34 / $912.01 / $3,981.07
| Professional | | $562.34 | $912.01 | $3,981.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $58.88 / $70.79
| Professional | | $32.36 | $58.88 | $70.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,248.07 / $5,754.40 / $7,762.47
| Facility | | $5,248.07 | $5,754.40 | $7,762.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $724.44 / $1,288.25 / $1,778.28
| Professional | | $724.44 | $1,288.25 | $1,778.28 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11,481.54 / $21,379.62 / $31,622.78
| Facility | | $11,481.54 | $21,379.62 | $31,622.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,187.76 / $3,890.45 / $3,890.45
| Professional | | $2,187.76 | $3,890.45 | $3,890.45 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,897.79 / $7,585.78 / $9,772.37
| Facility | | $4,897.79 | $7,585.78 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $549.54 / $794.33 / $2,089.30
| Professional | | $549.54 | $794.33 | $2,089.30 |