- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $724.44 / $6,025.60 / $18,620.87
| Facility | | $724.44 | $6,025.60 | $18,620.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $338.84 / $478.63 / $954.99
| Professional | | $338.84 | $478.63 | $954.99 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,235.94 / $4,466.84 / $8,709.64
| Facility | | $3,235.94 | $4,466.84 | $8,709.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $512.86 / $724.44 / $977.24
| Professional | | $512.86 | $724.44 | $977.24 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $630.96 / $758.58 / $2,398.83
| Facility | | $630.96 | $758.58 | $2,398.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $354.81 / $616.60 / $1,071.52
| Professional | | $354.81 | $616.60 | $1,071.52 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $371.54 / $741.31 / $2,041.74
| Facility | | $371.54 | $741.31 | $2,041.74 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $371.54 / $707.95 / $1,548.82
| Professional | | $371.54 | $707.95 | $1,548.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $173.78
| Professional | | $32.36 | $33.11 | $173.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $524.81 / $676.08 / $758.58
| Facility | | $524.81 | $676.08 | $758.58 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $501.19 / $512.86 / $537.03
| Facility | | $501.19 | $512.86 | $537.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $512.86 / $758.58 / $977.24
| Professional | | $512.86 | $758.58 | $977.24 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,311.31 / $4,466.84 / $8,709.64
| Facility | | $3,311.31 | $4,466.84 | $8,709.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $512.86 / $724.44 / $977.24
| Professional | | $512.86 | $724.44 | $977.24 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,479.11 / $5,011.87 / $10,471.29
| Facility | | $1,479.11 | $5,011.87 | $10,471.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $371.54 / $524.81 / $954.99
| Professional | | $371.54 | $524.81 | $954.99 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $407.38 / $426.58 / $776.25
| Professional | | $407.38 | $426.58 | $776.25 |