- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $457.09 / $977.24 / $14,454.40
| Facility | | $457.09 | $977.24 | $14,454.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $426.58 / $478.63 / $1,202.26
| Professional | | $426.58 | $478.63 | $1,202.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,981.07 / $7,762.47 / $12,589.25
| Facility | | $3,981.07 | $7,762.47 | $12,589.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $457.09 / $912.01 / $2,454.71
| Professional | | $457.09 | $912.01 | $2,454.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,230.27 / $1,445.44 / $2,454.71
| Facility | | $1,230.27 | $1,445.44 | $2,454.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $537.03 / $1,995.26 / $2,398.83
| Professional | | $537.03 | $1,995.26 | $2,398.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $457.09 / $977.24 / $5,754.40
| Facility | | $457.09 | $977.24 | $5,754.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $851.14 / $1,148.15 / $1,479.11
| Professional | | $851.14 | $1,148.15 | $1,479.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $478.63 / $977.24 / $6,165.95
| Facility | | $478.63 | $977.24 | $6,165.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $478.63 / $851.14 / $4,677.35
| Professional | | $478.63 | $851.14 | $4,677.35 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $70.79
| Professional | | $32.36 | $33.11 | $70.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $912.01 / $3,890.45 / $4,570.88
| Facility | | $912.01 | $3,890.45 | $4,570.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $588.84 / $1,096.48 / $1,905.46
| Professional | | $588.84 | $1,096.48 | $1,905.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $724.44 / $1,096.48 / $1,621.81
| Professional | | $724.44 | $1,096.48 | $1,621.81 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,235.94 / $6,025.60 / $8,912.51
| Facility | | $3,235.94 | $6,025.60 | $8,912.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $851.14 / $2,238.72 / $4,897.79
| Professional | | $851.14 | $2,238.72 | $4,897.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,513.56 / $1,513.56 / $1,513.56
| Professional | | $1,513.56 | $1,513.56 | $1,513.56 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,148.15 / $2,570.40 / $3,019.95
| Professional | | $1,148.15 | $2,570.40 | $3,019.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,884.03 / $3,548.13 / $7,244.36
| Facility | | $2,884.03 | $3,548.13 | $7,244.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $457.09 / $707.95 / $1,905.46
| Professional | | $457.09 | $707.95 | $1,905.46 |