- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $758.58 / $6,918.31 / $12,022.64
| Facility | | $758.58 | $6,918.31 | $12,022.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $436.52 / $1,445.44 / $10,232.93
| Professional | | $436.52 | $1,445.44 | $10,232.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $602.56 / $602.56 / $12,022.64
| Professional | | $602.56 | $602.56 | $12,022.64 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,606.93 / $6,606.93 / $6,760.83
| Facility | | $6,606.93 | $6,606.93 | $6,760.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $630.96 / $5,888.44 / $17,378.01
| Professional | | $630.96 | $5,888.44 | $17,378.01 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $602.56 / $602.56 / $6,309.57
| Facility | | $602.56 | $602.56 | $6,309.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $562.34 / $1,621.81 / $12,882.50
| Professional | | $562.34 | $1,621.81 | $12,882.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15,488.17 / $15,488.17 / $15,488.17
| Professional | | $15,488.17 | $15,488.17 | $15,488.17 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $467.74 / $4,570.88 / $9,772.37
| Facility | | $467.74 | $4,570.88 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8,912.51 / $10,471.29 / $12,302.69
| Professional | | $8,912.51 | $10,471.29 | $12,302.69 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,623.41 / $14,454.40 / $23,442.29
| Facility | | $5,623.41 | $14,454.40 | $23,442.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $467.74 / $4,466.84 / $12,022.64
| Professional | | $467.74 | $4,466.84 | $12,022.64 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $56.23 / $20,892.96 / $20,892.96
| Facility | | $56.23 | $20,892.96 | $20,892.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $52,480.75 / $52,480.75 / $52,480.75
| Professional | | $52,480.75 | $52,480.75 | $52,480.75 |