- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,621.81 / $4,466.84 / $5,495.41
| Facility | | $1,621.81 | $4,466.84 | $5,495.41 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $426.58 / $794.33 / $1,548.82
| Professional | | $426.58 | $794.33 | $1,548.82 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,122.02 / $5,248.07 / $15,135.61
| Facility | | $1,122.02 | $5,248.07 | $15,135.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $758.58 / $1,047.13 / $1,412.54
| Professional | | $758.58 | $1,047.13 | $1,412.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,466.84 / $4,466.84 / $4,466.84
| Facility | | $4,466.84 | $4,466.84 | $4,466.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $398.11 / $724.44 / $1,202.26
| Professional | | $398.11 | $724.44 | $1,202.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $426.58 / $794.33 / $1,621.81
| Facility | | $426.58 | $794.33 | $1,621.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $758.58 / $1,148.15 / $1,548.82
| Professional | | $758.58 | $1,148.15 | $1,548.82 |
- 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
- $776.25 / $1,047.13 / $1,548.82
| Professional | | $776.25 | $1,047.13 | $1,548.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $630.96 / $794.33 / $5,495.41
| Professional | | $630.96 | $794.33 | $5,495.41 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $676.08 / $6,165.95 / $7,762.47
| Facility | | $676.08 | $6,165.95 | $7,762.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $389.05 / $707.95 / $1,202.26
| Professional | | $389.05 | $707.95 | $1,202.26 |