- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $562.34 / $5,248.07 / $8,128.31
| Facility | | $562.34 | $5,248.07 | $8,128.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $562.34 / $776.25 / $1,698.24
| Professional | | $562.34 | $776.25 | $1,698.24 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,630.27 / $4,570.88 / $7,079.46
| Facility | | $2,630.27 | $4,570.88 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $794.33 / $1,584.89 / $3,548.13
| Professional | | $794.33 | $1,584.89 | $3,548.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,187.76 / $2,570.40 / $4,168.69
| Facility | | $2,187.76 | $2,570.40 | $4,168.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $691.83 / $1,380.38 / $2,511.89
| Professional | | $691.83 | $1,380.38 | $2,511.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $630.96 / $1,819.70 / $5,128.61
| Facility | | $630.96 | $1,819.70 | $5,128.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,230.27 / $1,778.28 / $2,454.71
| Professional | | $1,230.27 | $1,778.28 | $2,454.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $660.69 / $1,819.70 / $7,762.47
| Facility | | $660.69 | $1,819.70 | $7,762.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $794.33 / $1,445.44 / $5,011.87
| Professional | | $794.33 | $1,445.44 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $1,949.84
| Professional | | $32.36 | $33.11 | $1,949.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,348.96 / $5,754.40 / $7,762.47
| Facility | | $1,348.96 | $5,754.40 | $7,762.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $912.01 / $1,905.46 / $2,951.21
| Professional | | $912.01 | $1,905.46 | $2,951.21 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,174.90 / $1,905.46 / $2,884.03
| Professional | | $1,174.90 | $1,905.46 | $2,884.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,801.89 / $5,623.41 / $5,623.41
| Facility | | $3,801.89 | $5,623.41 | $5,623.41 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $676.08 / $1,230.27 / $6,025.60
| Professional | | $676.08 | $1,230.27 | $6,025.60 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,230.27 / $1,230.27 / $1,548.82
| Professional | | $1,230.27 | $1,230.27 | $1,548.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,230.27 / $2,818.38 / $3,630.78
| Professional | | $1,230.27 | $2,818.38 | $3,630.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,786.30 / $7,413.10 / $9,120.11
| Facility | | $4,786.30 | $7,413.10 | $9,120.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $676.08 / $1,122.02 / $2,818.38
| Professional | | $676.08 | $1,122.02 | $2,818.38 |