- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $912.01 / $3,630.78 / $12,022.64
| Facility | | $912.01 | $3,630.78 | $12,022.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $891.25 / $1,071.52 / $1,659.59
| Professional | | $891.25 | $1,071.52 | $1,659.59 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,511.89 / $4,466.84 / $8,317.64
| Facility | | $2,511.89 | $4,466.84 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $912.01 / $1,096.48 / $1,513.56
| Professional | | $912.01 | $1,096.48 | $1,513.56 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $79.43 / $891.25 / $912.01
| Facility | | $79.43 | $891.25 | $912.01 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,698.24 / $1,698.24 / $1,698.24
| Facility | | $1,698.24 | $1,698.24 | $1,698.24 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $933.25 / $1,348.96 / $2,137.96
| Professional | | $933.25 | $1,348.96 | $2,137.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9,332.54 / $45,708.82 / $45,708.82
| Facility | | $9,332.54 | $45,708.82 | $45,708.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7,413.10 / $8,128.31 / $8,128.31
| Professional | | $7,413.10 | $8,128.31 | $8,128.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $891.25 / $1,380.38 / $4,265.80
| Facility | | $891.25 | $1,380.38 | $4,265.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $912.01 / $1,288.25 / $2,089.30
| Professional | | $912.01 | $1,288.25 | $2,089.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $128.82 / $831.76
| Professional | | $32.36 | $128.82 | $831.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,148.15 / $1,148.15 / $1,148.15
| Professional | | $1,148.15 | $1,148.15 | $1,148.15 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $912.01 / $1,202.26 / $2,137.96
| Facility | | $912.01 | $1,202.26 | $2,137.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $933.25 / $1,318.26 / $2,089.30
| Professional | | $933.25 | $1,318.26 | $2,089.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,737.80 / $4,786.30 / $9,120.11
| Facility | | $1,737.80 | $4,786.30 | $9,120.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $794.33 / $1,047.13 / $1,621.81
| Professional | | $794.33 | $1,047.13 | $1,621.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $891.25 / $912.01 / $933.25
| Professional | | $891.25 | $912.01 | $933.25 |