- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,148.15 / $3,388.44 / $8,511.38
| Facility | | $1,148.15 | $3,388.44 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $524.81 / $831.76 / $2,344.23
| Professional | | $524.81 | $831.76 | $2,344.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,388.44 / $4,365.16 / $8,511.38
| Facility | | $3,388.44 | $4,365.16 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $549.54 / $912.01 / $1,258.93
| Professional | | $549.54 | $912.01 | $1,258.93 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,318.26 / $1,318.26 / $1,318.26
| Facility | | $1,318.26 | $1,318.26 | $1,318.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $660.69 / $1,348.96 / $1,819.70
| Professional | | $660.69 | $1,348.96 | $1,819.70 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $575.44 / $977.24 / $2,691.53
| Facility | | $575.44 | $977.24 | $2,691.53 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $691.83 / $1,230.27 / $4,677.35
| Professional | | $691.83 | $1,230.27 | $4,677.35 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,288.25 / $1,380.38 / $1,819.70
| Professional | | $1,288.25 | $1,380.38 | $1,819.70 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,318.26 / $1,318.26 / $1,318.26
| Facility | | $1,318.26 | $1,318.26 | $1,318.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,122.02 / $1,412.54 / $1,949.84
| Professional | | $1,122.02 | $1,412.54 | $1,949.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,096.48 / $1,995.26 / $3,801.89
| Facility | | $1,096.48 | $1,995.26 | $3,801.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $645.65 / $1,023.29 / $1,513.56
| Professional | | $645.65 | $1,023.29 | $1,513.56 |