- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $588.84 / $4,265.80 / $8,317.64
| Facility | | $588.84 | $4,265.80 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $346.74 / $645.65 / $1,737.80
| Professional | | $346.74 | $645.65 | $1,737.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $263.03 / $575.44 / $1,047.13
| Professional | | $263.03 | $575.44 | $1,047.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $478.63 / $741.31 / $1,621.81
| Professional | | $478.63 | $741.31 | $1,621.81 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $602.56 / $602.56 / $602.56
| Facility | | $602.56 | $602.56 | $602.56 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $407.38 / $676.08 / $1,258.93
| Professional | | $407.38 | $676.08 | $1,258.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $741.31 / $741.31 / $1,445.44
| Professional | | $741.31 | $741.31 | $1,445.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $407.38 / $616.60 / $1,071.52
| Facility | | $407.38 | $616.60 | $1,071.52 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,370.32 / $5,370.32 / $8,511.38
| Facility | | $5,370.32 | $5,370.32 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $602.56 / $933.25 / $1,318.26
| Professional | | $602.56 | $933.25 | $1,318.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,187.76 / $7,079.46 / $10,715.19
| Facility | | $2,187.76 | $7,079.46 | $10,715.19 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $371.54 / $588.84 / $1,122.02
| Professional | | $371.54 | $588.84 | $1,122.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7,079.46 / $7,079.46 / $45,708.82
| Facility | | $7,079.46 | $7,079.46 | $45,708.82 |
- Facility/Professional
- Facility
- Modifier
- AS
- Typical Low / Median / Typical High
- $707.95 / $707.95 / $707.95
| Facility | AS | $707.95 | $707.95 | $707.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4,265.80 / $4,265.80 / $5,128.61
| Professional | | $4,265.80 | $4,265.80 | $5,128.61 |