- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,137.96 / $6,309.57 / $16,595.87
| Facility | | $2,137.96 | $6,309.57 | $16,595.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $263.03 / $457.09 / $1,621.81
| Professional | | $263.03 | $457.09 | $1,621.81 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,548.13 / $6,025.60 / $13,489.63
| Facility | | $3,548.13 | $6,025.60 | $13,489.63 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $316.23 / $512.86 / $1,258.93
| Professional | | $316.23 | $512.86 | $1,258.93 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $85.11 / $4,466.84 / $8,912.51
| Facility | | $85.11 | $4,466.84 | $8,912.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $257.04 / $457.09 / $1,047.13
| Professional | | $257.04 | $457.09 | $1,047.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $891.25 / $891.25 / $1,047.13
| Facility | | $891.25 | $891.25 | $1,047.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $302.00 / $501.19 / $1,122.02
| Professional | | $302.00 | $501.19 | $1,122.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $173.78 / $380.19 / $812.83
| Professional | | $173.78 | $380.19 | $812.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $331.13 / $549.54 / $977.24
| Professional | | $331.13 | $549.54 | $977.24 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,168.69 / $28,840.32 / $28,840.32
| Facility | | $4,168.69 | $28,840.32 | $28,840.32 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,311.31 / $3,890.45 / $3,890.45
| Professional | | $3,311.31 | $3,890.45 | $3,890.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $398.11 / $398.11 / $660.69
| Professional | | $398.11 | $398.11 | $660.69 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $302.00 / $501.19 / $870.96
| Facility | | $302.00 | $501.19 | $870.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $302.00 / $501.19 / $1,047.13
| Professional | | $302.00 | $501.19 | $1,047.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,000.00 / $1,000.00 / $1,548.82
| Professional | | $1,000.00 | $1,000.00 | $1,548.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $218.78 / $316.23 / $562.34
| Professional | | $218.78 | $316.23 | $562.34 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,548.13 / $7,079.46 / $15,135.61
| Facility | | $3,548.13 | $7,079.46 | $15,135.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $257.04 / $436.52 / $1,096.48
| Professional | | $257.04 | $436.52 | $1,096.48 |