- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,096.48 / $4,073.80 / $10,964.78
| Facility | | $1,096.48 | $4,073.80 | $10,964.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $724.44 / $891.25 / $2,187.76
| Professional | | $724.44 | $891.25 | $2,187.76 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,897.79 / $11,220.18 / $18,620.87
| Facility | | $4,897.79 | $11,220.18 | $18,620.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $660.69 / $831.76 / $1,949.84
| Professional | | $660.69 | $831.76 | $1,949.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,122.02 / $2,398.83 / $10,964.78
| Facility | | $1,122.02 | $2,398.83 | $10,964.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,122.02 / $1,122.02 / $1,122.02
| Professional | | $1,122.02 | $1,122.02 | $1,122.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,348.96 / $2,290.87 / $50,118.72
| Facility | | $1,348.96 | $2,290.87 | $50,118.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $794.33 / $1,230.27 / $3,630.78
| Professional | | $794.33 | $1,230.27 | $3,630.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $851.14 / $1,258.93 / $2,951.21
| Facility | | $851.14 | $1,258.93 | $2,951.21 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $812.83 / $1,202.26 / $1,737.80
| Professional | | $812.83 | $1,202.26 | $1,737.80 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $758.58 / $758.58 / $758.58
| Facility | | $758.58 | $758.58 | $758.58 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $660.69 / $1,023.29 / $1,698.24
| Professional | | $660.69 | $1,023.29 | $1,698.24 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $812.83 / $50,118.72 / $75,857.76
| Facility | | $812.83 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $398.11 / $1,047.13 / $2,187.76
| Professional | | $398.11 | $1,047.13 | $2,187.76 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,454.71 / $6,309.57 / $15,488.17
| Facility | | $2,454.71 | $6,309.57 | $15,488.17 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $724.44 / $1,096.48 / $3,311.31
| Professional | | $724.44 | $1,096.48 | $3,311.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $645.65 / $954.99 / $3,548.13
| Facility | | $645.65 | $954.99 | $3,548.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $645.65 / $954.99 / $2,344.23
| Professional | | $645.65 | $954.99 | $2,344.23 |