- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $457.09 / $3,090.30 / $5,128.61
| Facility | | $457.09 | $3,090.30 | $5,128.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $229.09 / $436.52 / $891.25
| Professional | | $229.09 | $436.52 | $891.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $588.84 / $4,897.79 / $45,708.82
| Facility | | $588.84 | $4,897.79 | $45,708.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $269.15 / $549.54 / $1,584.89
| Professional | | $269.15 | $549.54 | $1,584.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $295.12 / $295.12 / $691.83
| Facility | | $295.12 | $295.12 | $691.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $295.12 / $562.34 / $1,023.29
| Professional | | $295.12 | $562.34 | $1,023.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $269.15 / $512.86 / $1,071.52
| Professional | | $269.15 | $512.86 | $1,071.52 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $239.88 / $338.84 / $3,630.78
| Facility | | $239.88 | $338.84 | $3,630.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $562.34 / $691.83 / $912.01
| Professional | | $562.34 | $691.83 | $912.01 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,041.74 / $4,265.80 / $9,772.37
| Facility | | $2,041.74 | $4,265.80 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $281.84 / $602.56 / $1,288.25
| Professional | | $281.84 | $602.56 | $1,288.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9,332.54 / $9,332.54 / $9,332.54
| Facility | | $9,332.54 | $9,332.54 | $9,332.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $831.76 / $831.76 / $831.76
| Professional | | $831.76 | $831.76 | $831.76 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $588.84 / $4,897.79 / $45,708.82
| Facility | | $588.84 | $4,897.79 | $45,708.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $269.15 / $549.54 / $1,584.89
| Professional | | $269.15 | $549.54 | $1,584.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,862.09 / $3,981.07 / $9,549.93
| Facility | | $1,862.09 | $3,981.07 | $9,549.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $281.84 / $602.56 / $1,318.26
| Professional | | $281.84 | $602.56 | $1,318.26 |