- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $426.58 / $891.25 / $3,090.30
| Facility | | $426.58 | $891.25 | $3,090.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $398.11 / $478.63 / $1,096.48
| Professional | | $398.11 | $478.63 | $1,096.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,311.31 / $4,786.30 / $7,585.78
| Facility | | $3,311.31 | $4,786.30 | $7,585.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $457.09 / $870.96 / $2,089.30
| Professional | | $457.09 | $870.96 | $2,089.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,258.93 / $1,479.11 / $2,344.23
| Facility | | $1,258.93 | $1,479.11 | $2,344.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $524.81 / $1,122.02 / $2,238.72
| Professional | | $524.81 | $1,122.02 | $2,238.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $436.52 / $676.08 / $3,548.13
| Facility | | $436.52 | $676.08 | $3,548.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $812.83 / $1,071.52 / $1,412.54
| Professional | | $812.83 | $1,071.52 | $1,412.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $436.52 / $758.58 / $7,244.36
| Facility | | $436.52 | $758.58 | $7,244.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $489.78 / $977.24 / $3,548.13
| Professional | | $489.78 | $977.24 | $3,548.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $549.54
| Professional | | $32.36 | $33.11 | $549.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $851.14 / $5,754.40 / $7,762.47
| Facility | | $851.14 | $5,754.40 | $7,762.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $602.56 / $1,122.02 / $1,905.46
| Professional | | $602.56 | $1,122.02 | $1,905.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $794.33 / $1,258.93 / $1,778.28
| Professional | | $794.33 | $1,258.93 | $1,778.28 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,737.80 / $3,235.94 / $4,786.30
| Facility | | $1,737.80 | $3,235.94 | $4,786.30 |
- Facility/Professional
- Facility
- Modifier
- 54
- Typical Low / Median / Typical High
- $2,238.72 / $2,238.72 / $3,311.31
| Facility | 54 | $2,238.72 | $2,238.72 | $3,311.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $691.83 / $2,238.72 / $3,467.37
| Professional | | $691.83 | $2,238.72 | $3,467.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,380.38 / $1,380.38 / $1,548.82
| Professional | | $1,380.38 | $1,380.38 | $1,548.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $794.33 / $2,754.23 / $3,090.30
| Professional | | $794.33 | $2,754.23 | $3,090.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,073.80 / $7,413.10 / $9,120.11
| Facility | | $4,073.80 | $7,413.10 | $9,120.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $95.50 / $912.01 / $2,570.40
| Professional | | $95.50 | $912.01 | $2,570.40 |