- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $912.01 / $1,548.82 / $18,620.87
| Facility | | $912.01 | $1,548.82 | $18,620.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $489.78 / $758.58 / $1,819.70
| Professional | | $489.78 | $758.58 | $1,819.70 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $501.19 / $676.08 / $1,348.96
| Facility | | $501.19 | $676.08 | $1,348.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $691.83 / $1,096.48 / $1,621.81
| Professional | | $691.83 | $1,096.48 | $1,621.81 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $295.12 / $707.95 / $870.96
| Facility | | $295.12 | $707.95 | $870.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $616.60 / $1,023.29 / $1,819.70
| Professional | | $616.60 | $1,023.29 | $1,819.70 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $338.84 / $1,000.00 / $1,659.59
| Facility | | $338.84 | $1,000.00 | $1,659.59 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $446.68 / $1,023.29 / $1,659.59
| Professional | | $446.68 | $1,023.29 | $1,659.59 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $257.04
| Professional | | $32.36 | $33.11 | $257.04 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $851.14 / $1,348.96 / $1,479.11
| Facility | | $851.14 | $1,348.96 | $1,479.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $239.88 / $891.25 / $933.25
| Facility | | $239.88 | $891.25 | $933.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $660.69 / $1,023.29 / $1,659.59
| Professional | | $660.69 | $1,023.29 | $1,659.59 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $501.19 / $691.83 / $1,318.26
| Facility | | $501.19 | $691.83 | $1,318.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $691.83 / $1,096.48 / $1,621.81
| Professional | | $691.83 | $1,096.48 | $1,621.81 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $218.78 / $812.83 / $1,905.46
| Facility | | $218.78 | $812.83 | $1,905.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $645.65 / $954.99 / $1,584.89
| Professional | | $645.65 | $954.99 | $1,584.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $457.09 / $812.83 / $1,023.29
| Professional | | $457.09 | $812.83 | $1,023.29 |