- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $549.54 / $1,258.93 / $6,456.54
| Facility | | $549.54 | $1,258.93 | $6,456.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $524.81 / $691.83 / $1,548.82
| Professional | | $524.81 | $691.83 | $1,548.82 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,311.31 / $4,786.30 / $7,585.78
| Facility | | $3,311.31 | $4,786.30 | $7,585.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $588.84 / $1,096.48 / $2,754.23
| Professional | | $588.84 | $1,096.48 | $2,754.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,089.30 / $2,454.71 / $3,890.45
| Facility | | $2,089.30 | $2,454.71 | $3,890.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $660.69 / $1,737.80 / $3,162.28
| Professional | | $660.69 | $1,737.80 | $3,162.28 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $549.54 / $933.25 / $4,897.79
| Facility | | $549.54 | $933.25 | $4,897.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,122.02 / $1,548.82 / $1,995.26
| Professional | | $1,122.02 | $1,548.82 | $1,995.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $549.54 / $1,047.13 / $7,943.28
| Facility | | $549.54 | $1,047.13 | $7,943.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $562.34 / $1,230.27 / $5,623.41
| Professional | | $562.34 | $1,230.27 | $5,623.41 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $616.60
| Professional | | $32.36 | $33.11 | $616.60 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $977.24 / $5,754.40 / $7,762.47
| Facility | | $977.24 | $5,754.40 | $7,762.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $933.25 / $1,445.44 / $2,511.89
| Professional | | $933.25 | $1,445.44 | $2,511.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,071.52 / $1,819.70 / $2,630.27
| Professional | | $1,071.52 | $1,819.70 | $2,630.27 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,344.23 / $4,073.80 / $4,073.80
| Facility | | $2,344.23 | $4,073.80 | $4,073.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $977.24 / $3,090.30 / $5,370.32
| Professional | | $977.24 | $3,090.30 | $5,370.32 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,862.09 / $1,862.09 / $2,290.87
| Professional | | $1,862.09 | $1,862.09 | $2,290.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,905.46 / $3,890.45 / $4,897.79
| Professional | | $1,905.46 | $3,890.45 | $4,897.79 |
- 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
- $512.86 / $891.25 / $2,290.87
| Professional | | $512.86 | $891.25 | $2,290.87 |