- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $870.96 / $1,548.82 / $17,782.79
| Facility | | $870.96 | $1,548.82 | $17,782.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $398.11 / $602.56 / $1,348.96
| Professional | | $398.11 | $602.56 | $1,348.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,174.90 / $1,659.59 / $3,388.44
| Facility | | $1,174.90 | $1,659.59 | $3,388.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $630.96 / $912.01 / $1,513.56
| Professional | | $630.96 | $912.01 | $1,513.56 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $512.86 / $562.34 / $912.01
| Facility | | $512.86 | $562.34 | $912.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $562.34 / $912.01 / $1,659.59
| Professional | | $562.34 | $912.01 | $1,659.59 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $575.44 / $977.24 / $1,548.82
| Facility | | $575.44 | $977.24 | $1,548.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $616.60 / $977.24 / $1,445.44
| Professional | | $616.60 | $977.24 | $1,445.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $208.93
| Professional | | $32.36 | $33.11 | $208.93 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $645.65 / $1,071.52 / $1,202.26
| Facility | | $645.65 | $1,071.52 | $1,202.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $354.81 / $812.83 / $812.83
| Facility | | $354.81 | $812.83 | $812.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $630.96 / $891.25 / $1,445.44
| Professional | | $630.96 | $891.25 | $1,445.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,148.15 / $1,737.80 / $3,388.44
| Facility | | $1,148.15 | $1,737.80 | $3,388.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $630.96 / $912.01 / $1,412.54
| Professional | | $630.96 | $912.01 | $1,412.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $645.65 / $2,344.23 / $5,011.87
| Facility | | $645.65 | $2,344.23 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $562.34 / $741.31 / $1,445.44
| Professional | | $562.34 | $741.31 | $1,445.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $478.63 / $691.83 / $912.01
| Professional | | $478.63 | $691.83 | $912.01 |