- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $478.63 / $4,677.35 / $18,620.87
| Facility | | $478.63 | $4,677.35 | $18,620.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $229.09 / $478.63 / $1,230.27
| Professional | | $229.09 | $478.63 | $1,230.27 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $158.49 / $158.49 / $446.68
| Professional | | $158.49 | $158.49 | $446.68 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,370.32 / $7,585.78 / $15,488.17
| Facility | | $5,370.32 | $7,585.78 | $15,488.17 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $371.54 / $645.65 / $1,148.15
| Professional | | $371.54 | $645.65 | $1,148.15 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $707.95 / $870.96 / $3,388.44
| Facility | | $707.95 | $870.96 | $3,388.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $288.40 / $575.44 / $1,230.27
| Professional | | $288.40 | $575.44 | $1,230.27 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $302.00 / $616.60 / $2,344.23
| Facility | | $302.00 | $616.60 | $2,344.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $302.00 / $602.56 / $1,412.54
| Professional | | $302.00 | $602.56 | $1,412.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $218.78
| Professional | | $32.36 | $33.11 | $218.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $549.54 / $912.01 / $912.01
| Facility | | $549.54 | $912.01 | $912.01 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $630.96 / $630.96 / $741.31
| Facility | | $630.96 | $630.96 | $741.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $338.84 / $630.96 / $1,148.15
| Professional | | $338.84 | $630.96 | $1,148.15 |
- 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
- $363.08 / $645.65 / $1,148.15
| Professional | | $363.08 | $645.65 | $1,148.15 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,137.96 / $8,912.51 / $16,595.87
| Facility | | $2,137.96 | $8,912.51 | $16,595.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $309.03 / $575.44 / $1,071.52
| Professional | | $309.03 | $575.44 | $1,071.52 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $257.04 / $489.78 / $724.44
| Professional | | $257.04 | $489.78 | $724.44 |