- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,786.30 / $5,495.41 / $6,918.31
| Facility | | $4,786.30 | $5,495.41 | $6,918.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $524.81 / $758.58 / $1,348.96
| Professional | | $524.81 | $758.58 | $1,348.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,737.80 / $7,413.10 / $15,135.61
| Facility | | $1,737.80 | $7,413.10 | $15,135.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $851.14 / $1,047.13 / $1,288.25
| Professional | | $851.14 | $1,047.13 | $1,288.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,467.37 / $3,467.37 / $3,548.13
| Facility | | $3,467.37 | $3,467.37 | $3,548.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $562.34 / $758.58 / $1,148.15
| Professional | | $562.34 | $758.58 | $1,148.15 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $501.19 / $891.25 / $1,513.56
| Facility | | $501.19 | $891.25 | $1,513.56 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $812.83 / $1,174.90 / $1,445.44
| Professional | | $812.83 | $1,174.90 | $1,445.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $32.36 / $33.11
| Professional | | $32.36 | $32.36 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9,772.37 / $13,182.57 / $18,620.87
| Facility | | $9,772.37 | $13,182.57 | $18,620.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $870.96 / $1,096.48 / $1,412.54
| Professional | | $870.96 | $1,096.48 | $1,412.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $588.84 / $912.01 / $9,332.54
| Professional | | $588.84 | $912.01 | $9,332.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,348.96 / $5,495.41 / $12,302.69
| Facility | | $1,348.96 | $5,495.41 | $12,302.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $562.34 / $831.76 / $1,288.25
| Professional | | $562.34 | $831.76 | $1,288.25 |