- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $851.14 / $11,481.54 / $20,892.96
| Facility | | $851.14 | $11,481.54 | $20,892.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $407.38 / $575.44 / $1,202.26
| Professional | | $407.38 | $575.44 | $1,202.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,570.88 / $17,378.01 / $35,481.34
| Facility | | $4,570.88 | $17,378.01 | $35,481.34 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $630.96 / $870.96 / $1,230.27
| Professional | | $630.96 | $870.96 | $1,230.27 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $707.95 / $758.58 / $870.96
| Facility | | $707.95 | $758.58 | $870.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $436.52 / $741.31 / $1,348.96
| Professional | | $436.52 | $741.31 | $1,348.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $467.74 / $912.01 / $3,890.45
| Facility | | $467.74 | $912.01 | $3,890.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $467.74 / $870.96 / $2,951.21
| Professional | | $467.74 | $870.96 | $2,951.21 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $64.57
| Professional | | $32.36 | $33.11 | $64.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $524.81 / $870.96 / $912.01
| Facility | | $524.81 | $870.96 | $912.01 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $616.60 / $630.96 / $2,187.76
| Facility | | $616.60 | $630.96 | $2,187.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $630.96 / $912.01 / $1,202.26
| Professional | | $630.96 | $912.01 | $1,202.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12,022.64 / $18,197.01 / $35,481.34
| Facility | | $12,022.64 | $18,197.01 | $35,481.34 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $630.96 / $870.96 / $1,230.27
| Professional | | $630.96 | $870.96 | $1,230.27 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,288.25 / $9,332.54 / $18,197.01
| Facility | | $1,288.25 | $9,332.54 | $18,197.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $478.63 / $645.65 / $1,174.90
| Professional | | $478.63 | $645.65 | $1,174.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $512.86 / $537.03 / $977.24
| Professional | | $512.86 | $537.03 | $977.24 |