- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $630.96 / $2,511.89 / $7,585.78
| Facility | | $630.96 | $2,511.89 | $7,585.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $309.03 / $363.08 / $645.65
| Professional | | $309.03 | $363.08 | $645.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $371.54 / $371.54 / $457.09
| Professional | | $371.54 | $371.54 | $457.09 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,174.90 / $2,187.76 / $4,265.80
| Facility | | $1,174.90 | $2,187.76 | $4,265.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $338.84 / $426.58 / $575.44
| Professional | | $338.84 | $426.58 | $575.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $79.43 / $354.81 / $354.81
| Facility | | $79.43 | $354.81 | $354.81 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $602.56 / $602.56 / $602.56
| Facility | | $602.56 | $602.56 | $602.56 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $316.23 / $446.68 / $691.83
| Professional | | $316.23 | $446.68 | $691.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $54.95 / $56.23 / $4,897.79
| Facility | | $54.95 | $56.23 | $4,897.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,691.53 / $3,162.28 / $3,162.28
| Professional | | $2,691.53 | $3,162.28 | $3,162.28 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $331.13 / $512.86 / $3,715.35
| Facility | | $331.13 | $512.86 | $3,715.35 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $331.13 / $489.78 / $741.31
| Professional | | $331.13 | $489.78 | $741.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $331.13
| Professional | | $32.36 | $33.11 | $331.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $331.13 / $331.13 / $331.13
| Professional | | $331.13 | $331.13 | $331.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $316.23 / $416.87 / $724.44
| Facility | | $316.23 | $416.87 | $724.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $316.23 / $446.68 / $691.83
| Professional | | $316.23 | $446.68 | $691.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $173.78 / $1,071.52 / $2,511.89
| Facility | | $173.78 | $1,071.52 | $2,511.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $263.03 / $354.81 / $537.03
| Professional | | $263.03 | $354.81 | $537.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $346.74 / $363.08 / $371.54
| Professional | | $346.74 | $363.08 | $371.54 |