- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $630.96 / $3,630.78 / $8,317.64
| Facility | | $630.96 | $3,630.78 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $467.74 / $588.84 / $1,230.27
| Professional | | $467.74 | $588.84 | $1,230.27 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,090.30 / $3,981.07 / $4,466.84
| Facility | | $3,090.30 | $3,981.07 | $4,466.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $549.54 / $831.76 / $1,412.54
| Professional | | $549.54 | $831.76 | $1,412.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $616.60 / $794.33 / $6,760.83
| Professional | | $616.60 | $794.33 | $6,760.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $575.44 / $575.44 / $575.44
| Facility | | $575.44 | $575.44 | $575.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $489.78 / $660.69 / $1,230.27
| Professional | | $489.78 | $660.69 | $1,230.27 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $524.81 / $660.69 / $794.33
| Professional | | $524.81 | $660.69 | $794.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $707.95 / $891.25 / $1,318.26
| Professional | | $707.95 | $891.25 | $1,318.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $537.03 / $691.83 / $1,071.52
| Facility | | $537.03 | $691.83 | $1,071.52 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $645.65 / $645.65 / $645.65
| Professional | | $645.65 | $645.65 | $645.65 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $512.86 / $691.83 / $3,630.78
| Facility | | $512.86 | $691.83 | $3,630.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $512.86 / $691.83 / $3,630.78
| Professional | | $512.86 | $691.83 | $3,630.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,698.24 / $3,162.28 / $5,370.32
| Facility | | $1,698.24 | $3,162.28 | $5,370.32 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $407.38 / $645.65 / $1,071.52
| Professional | | $407.38 | $645.65 | $1,071.52 |