- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $776.25 / $2,238.72 / $11,481.54
| Facility | | $776.25 | $2,238.72 | $11,481.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $457.09 / $537.03 / $1,122.02
| Professional | | $457.09 | $537.03 | $1,122.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $891.25 / $891.25 / $891.25
| Professional | | $891.25 | $891.25 | $891.25 |
- 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
- $575.44 / $1,023.29 / $1,548.82
| Professional | | $575.44 | $1,023.29 | $1,548.82 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $851.14 / $851.14 / $6,760.83
| Facility | | $851.14 | $851.14 | $6,760.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $524.81 / $707.95 / $1,258.93
| Professional | | $524.81 | $707.95 | $1,258.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $851.14 / $851.14 / $1,122.02
| Professional | | $851.14 | $851.14 | $1,122.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $478.63 / $660.69 / $1,148.15
| Facility | | $478.63 | $660.69 | $1,148.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $676.08 / $912.01 / $1,258.93
| Professional | | $676.08 | $912.01 | $1,258.93 |
- 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
- $426.58 / $602.56 / $1,122.02
| Professional | | $426.58 | $602.56 | $1,122.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16,982.44 / $16,982.44 / $42,657.95
| Facility | | $16,982.44 | $16,982.44 | $42,657.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6,165.95 / $6,165.95 / $6,165.95
| Professional | | $6,165.95 | $6,165.95 | $6,165.95 |