- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $724.44 / $1,659.59 / $9,332.54
| Facility | | $724.44 | $1,659.59 | $9,332.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $724.44 / $1,047.13 / $2,754.23
| Professional | | $724.44 | $1,047.13 | $2,754.23 |
- Facility/Professional
- Professional
- Modifier
- AS
- Typical Low / Median / Typical High
- $25.12 / $269.15 / $1,148.15
| Professional | AS | $25.12 | $269.15 | $1,148.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $501.19 / $954.99 / $1,071.52
| Professional | | $501.19 | $954.99 | $1,071.52 |
- Facility/Professional
- Professional
- Modifier
- AS
- Typical Low / Median / Typical High
- $67.61 / $67.61 / $67.61
| Professional | AS | $67.61 | $67.61 | $67.61 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,365.16 / $13,803.84 / $19,054.61
| Facility | | $4,365.16 | $13,803.84 | $19,054.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $851.14 / $1,230.27 / $1,862.09
| Professional | | $851.14 | $1,230.27 | $1,862.09 |
- Facility/Professional
- Professional
- Modifier
- AS
- Typical Low / Median / Typical High
- $120.23 / $173.78 / $257.04
| Professional | AS | $120.23 | $173.78 | $257.04 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $812.83 / $1,023.29 / $1,122.02
| Facility | | $812.83 | $1,023.29 | $1,122.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $977.24 / $1,096.48 / $1,348.96
| Professional | | $977.24 | $1,096.48 | $1,348.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $870.96 / $1,202.26 / $2,187.76
| Facility | | $870.96 | $1,202.26 | $2,187.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $660.69 / $1,096.48 / $1,548.82
| Professional | | $660.69 | $1,096.48 | $1,548.82 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,951.21 / $7,762.47 / $10,964.78
| Facility | | $2,951.21 | $7,762.47 | $10,964.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $707.95 / $1,023.29 / $1,698.24
| Professional | | $707.95 | $1,023.29 | $1,698.24 |