- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,148.15 / $6,918.31 / $18,197.01
| Facility | | $1,148.15 | $6,918.31 | $18,197.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $457.09 / $4,786.30 / $10,232.93
| Professional | | $457.09 | $4,786.30 | $10,232.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $331.13 / $645.65 / $5,128.61
| Professional | | $331.13 | $645.65 | $5,128.61 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,412.54 / $6,165.95 / $12,302.69
| Facility | | $1,412.54 | $6,165.95 | $12,302.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $467.74 / $4,786.30 / $6,456.54
| Professional | | $467.74 | $4,786.30 | $6,456.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $323.59 / $3,467.37 / $3,801.89
| Facility | | $323.59 | $3,467.37 | $3,801.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $467.74 / $1,258.93 / $10,471.29
| Professional | | $467.74 | $1,258.93 | $10,471.29 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,456.54 / $13,489.63 / $23,442.29
| Facility | | $6,456.54 | $13,489.63 | $23,442.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,890.45 / $5,011.87 / $7,762.47
| Professional | | $3,890.45 | $5,011.87 | $7,762.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $363.08 / $7,079.46
| Professional | | $32.36 | $363.08 | $7,079.46 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,168.69 / $11,220.18 / $22,908.68
| Facility | | $4,168.69 | $11,220.18 | $22,908.68 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $426.58 / $4,073.80 / $10,232.93
| Professional | | $426.58 | $4,073.80 | $10,232.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $363.08 / $4,073.80 / $5,888.44
| Professional | | $363.08 | $4,073.80 | $5,888.44 |