- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $309.03 / $4,073.80 / $12,022.64
| Facility | | $309.03 | $4,073.80 | $12,022.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $169.82 / $1,737.80 / $4,786.30
| Professional | | $169.82 | $1,737.80 | $4,786.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,388.44 / $5,495.41 / $12,882.50
| Facility | | $3,388.44 | $5,495.41 | $12,882.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,949.84 / $2,454.71 / $5,623.41
| Professional | | $1,949.84 | $2,454.71 | $5,623.41 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $295.12 / $295.12 / $10,964.78
| Facility | | $295.12 | $295.12 | $10,964.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $295.12 / $295.12 / $3,801.89
| Professional | | $295.12 | $295.12 | $3,801.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $34.67 / $4,365.16 / $53,703.18
| Facility | | $34.67 | $4,365.16 | $53,703.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $251.19 / $1,659.59 / $9,332.54
| Professional | | $251.19 | $1,659.59 | $9,332.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $208.93 / $275.42 / $758.58
| Facility | | $208.93 | $275.42 | $758.58 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,691.53 / $3,715.35 / $5,248.07
| Professional | | $2,691.53 | $3,715.35 | $5,248.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,737.80 / $2,818.38 / $4,786.30
| Professional | | $1,737.80 | $2,818.38 | $4,786.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $194.98 / $50,118.72 / $75,857.76
| Facility | | $194.98 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,235.94 / $3,715.35 / $5,888.44
| Professional | | $3,235.94 | $3,715.35 | $5,888.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,344.23 / $4,897.79 / $10,232.93
| Facility | | $2,344.23 | $4,897.79 | $10,232.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $169.82 / $2,041.74 / $5,888.44
| Professional | | $169.82 | $2,041.74 | $5,888.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $165.96 / $223.87 / $602.56
| Facility | | $165.96 | $223.87 | $602.56 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $524.81 / $2,398.83 / $4,466.84
| Professional | | $524.81 | $2,398.83 | $4,466.84 |