- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.58 / $2,454.71 / $14,454.40
| Facility | | $0.58 | $2,454.71 | $14,454.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $676.08 / $794.33 / $1,513.56
| Professional | | $676.08 | $794.33 | $1,513.56 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,905.46 / $1,905.46 / $1,949.84
| Facility | | $1,905.46 | $1,905.46 | $1,949.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $489.78 / $933.25 / $2,137.96
| Professional | | $489.78 | $933.25 | $2,137.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,174.90 / $1,174.90 / $6,606.93
| Facility | | $1,174.90 | $1,174.90 | $6,606.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $707.95 / $977.24 / $1,621.81
| Professional | | $707.95 | $977.24 | $1,621.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,122.02 / $1,122.02 / $1,778.28
| Professional | | $1,122.02 | $1,122.02 | $1,778.28 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $724.44 / $933.25 / $1,445.44
| Facility | | $724.44 | $933.25 | $1,445.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,047.13 / $1,258.93 / $1,479.11
| Professional | | $1,047.13 | $1,258.93 | $1,479.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,344.23 / $6,918.31 / $10,715.19
| Facility | | $2,344.23 | $6,918.31 | $10,715.19 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $616.60 / $794.33 / $1,513.56
| Professional | | $616.60 | $794.33 | $1,513.56 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16,982.44 / $16,982.44 / $33,884.42
| Facility | | $16,982.44 | $16,982.44 | $33,884.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7,943.28 / $7,943.28 / $7,943.28
| Professional | | $7,943.28 | $7,943.28 | $7,943.28 |