- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $660.69 / $3,548.13 / $8,317.64
| Facility | | $660.69 | $3,548.13 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $363.08 / $501.19 / $1,023.29
| Professional | | $363.08 | $501.19 | $1,023.29 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,011.87 / $5,248.07 / $57,543.99
| Facility | | $5,011.87 | $5,248.07 | $57,543.99 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $512.86 / $676.08 / $954.99
| Professional | | $512.86 | $676.08 | $954.99 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $371.54 / $537.03 / $954.99
| Professional | | $371.54 | $537.03 | $954.99 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $645.65 / $891.25 / $1,122.02
| Professional | | $645.65 | $891.25 | $1,122.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $354.81 / $602.56 / $912.01
| Professional | | $354.81 | $602.56 | $912.01 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,691.53 / $9,120.11 / $16,595.87
| Facility | | $2,691.53 | $9,120.11 | $16,595.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $389.05 / $398.11 / $436.52
| Professional | | $389.05 | $398.11 | $436.52 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $645.65 / $2,398.83 / $8,317.64
| Facility | | $645.65 | $2,398.83 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $380.19 / $549.54 / $1,096.48
| Professional | | $380.19 | $549.54 | $1,096.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $812.83 / $851.14 / $1,148.15
| Professional | | $812.83 | $851.14 | $1,148.15 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $309.03 / $416.87 / $758.58
| Facility | | $309.03 | $416.87 | $758.58 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $380.19 / $416.87 / $562.34
| Professional | | $380.19 | $416.87 | $562.34 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,659.59 / $3,981.07 / $9,332.54
| Facility | | $1,659.59 | $3,981.07 | $9,332.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $363.08 / $549.54 / $933.25
| Professional | | $363.08 | $549.54 | $933.25 |