- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $707.95 / $1,148.15 / $18,620.87
| Facility | | $707.95 | $1,148.15 | $18,620.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $338.84 / $524.81 / $1,148.15
| Professional | | $338.84 | $524.81 | $1,148.15 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,388.44 / $7,585.78 / $15,488.17
| Facility | | $3,388.44 | $7,585.78 | $15,488.17 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $489.78 / $724.44 / $1,174.90
| Professional | | $489.78 | $724.44 | $1,174.90 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $416.87 / $489.78 / $741.31
| Facility | | $416.87 | $489.78 | $741.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $501.19 / $831.76 / $1,380.38
| Professional | | $501.19 | $831.76 | $1,380.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $537.03 / $891.25 / $1,513.56
| Facility | | $537.03 | $891.25 | $1,513.56 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $537.03 / $870.96 / $1,258.93
| Professional | | $537.03 | $870.96 | $1,258.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $169.82
| Professional | | $32.36 | $33.11 | $169.82 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $724.44 / $954.99 / $1,202.26
| Facility | | $724.44 | $954.99 | $1,202.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $407.38 / $645.65 / $676.08
| Facility | | $407.38 | $645.65 | $676.08 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $512.86 / $741.31 / $1,202.26
| Professional | | $512.86 | $741.31 | $1,202.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,248.07 / $7,943.28 / $15,488.17
| Facility | | $5,248.07 | $7,943.28 | $15,488.17 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $501.19 / $724.44 / $1,174.90
| Professional | | $501.19 | $724.44 | $1,174.90 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $912.01 / $8,912.51 / $16,595.87
| Facility | | $912.01 | $8,912.51 | $16,595.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $489.78 / $707.95 / $1,230.27
| Professional | | $489.78 | $707.95 | $1,230.27 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $363.08 / $549.54 / $691.83
| Professional | | $363.08 | $549.54 | $691.83 |