- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $501.19 / $1,047.13 / $13,489.63
| Facility | | $501.19 | $1,047.13 | $13,489.63 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $467.74 / $660.69 / $1,659.59
| Professional | | $467.74 | $660.69 | $1,659.59 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,165.95 / $10,232.93 / $17,378.01
| Facility | | $6,165.95 | $10,232.93 | $17,378.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $660.69 / $1,047.13 / $2,818.38
| Professional | | $660.69 | $1,047.13 | $2,818.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,778.28 / $2,089.30 / $3,467.37
| Facility | | $1,778.28 | $2,089.30 | $3,467.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $630.96 / $1,548.82 / $3,090.30
| Professional | | $630.96 | $1,548.82 | $3,090.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $512.86 / $1,000.00 / $6,165.95
| Facility | | $512.86 | $1,000.00 | $6,165.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $933.25 / $1,318.26 / $1,862.09
| Professional | | $933.25 | $1,318.26 | $1,862.09 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $512.86 / $1,047.13 / $7,943.28
| Facility | | $512.86 | $1,047.13 | $7,943.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $660.69 / $1,412.54 / $4,897.79
| Professional | | $660.69 | $1,412.54 | $4,897.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $724.44
| Professional | | $32.36 | $33.11 | $724.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,000.00 / $5,754.40 / $7,762.47
| Facility | | $1,000.00 | $5,754.40 | $7,762.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $812.83 / $1,584.89 / $2,290.87
| Professional | | $812.83 | $1,584.89 | $2,290.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $933.25 / $1,584.89 / $2,344.23
| Professional | | $933.25 | $1,584.89 | $2,344.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,025.60 / $11,220.18 / $16,595.87
| Facility | | $6,025.60 | $11,220.18 | $16,595.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $812.83 / $3,235.94 / $4,786.30
| Professional | | $812.83 | $3,235.94 | $4,786.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,659.59 / $1,659.59 / $2,187.76
| Professional | | $1,659.59 | $1,659.59 | $2,187.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,621.81 / $3,235.94 / $4,265.80
| Professional | | $1,621.81 | $3,235.94 | $4,265.80 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,786.30 / $7,585.78 / $9,120.11
| Facility | | $4,786.30 | $7,585.78 | $9,120.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $549.54 / $912.01 / $2,398.83
| Professional | | $549.54 | $912.01 | $2,398.83 |