- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $446.68 / $2,818.38 / $7,762.47
| Facility | | $446.68 | $2,818.38 | $7,762.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $309.03 / $407.38 / $870.96
| Professional | | $309.03 | $407.38 | $870.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,819.70 / $3,630.78 / $5,011.87
| Facility | | $1,819.70 | $3,630.78 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $309.03 / $389.05 / $851.14
| Professional | | $309.03 | $389.05 | $851.14 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $457.09 / $1,258.93 / $4,073.80
| Facility | | $457.09 | $1,258.93 | $4,073.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $457.09 / $457.09 / $489.78
| Professional | | $457.09 | $457.09 | $489.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $562.34 / $1,318.26 / $50,118.72
| Facility | | $562.34 | $1,318.26 | $50,118.72 |
- Facility/Professional
- Facility
- Modifier
- 54
- Typical Low / Median / Typical High
- $389.05 / $389.05 / $389.05
| Facility | 54 | $389.05 | $389.05 | $389.05 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $338.84 / $512.86 / $1,412.54
| Professional | | $338.84 | $512.86 | $1,412.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $363.08 / $478.63 / $1,288.25
| Facility | | $363.08 | $478.63 | $1,288.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $426.58 / $645.65 / $912.01
| Professional | | $426.58 | $645.65 | $912.01 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $338.84 / $338.84 / $338.84
| Facility | | $338.84 | $338.84 | $338.84 |
- Facility/Professional
- Facility
- Modifier
- 54
- Typical Low / Median / Typical High
- $269.15 / $269.15 / $269.15
| Facility | 54 | $269.15 | $269.15 | $269.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $281.84 / $478.63 / $758.58
| Professional | | $281.84 | $478.63 | $758.58 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $512.86 / $512.86 / $512.86
| Facility | | $512.86 | $512.86 | $512.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $416.87 / $478.63 / $933.25
| Professional | | $416.87 | $478.63 | $933.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $309.03 / $50,118.72 / $75,857.76
| Facility | | $309.03 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $398.11 / $467.74 / $977.24
| Professional | | $398.11 | $467.74 | $977.24 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,071.52 / $2,398.83 / $4,897.79
| Facility | | $1,071.52 | $2,398.83 | $4,897.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $295.12 / $457.09 / $1,412.54
| Professional | | $295.12 | $457.09 | $1,412.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $269.15 / $398.11 / $1,318.26
| Facility | | $269.15 | $398.11 | $1,318.26 |
- Facility/Professional
- Facility
- Modifier
- 54
- Typical Low / Median / Typical High
- $213.80 / $229.09 / $316.23
| Facility | 54 | $213.80 | $229.09 | $316.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $295.12 / $426.58 / $977.24
| Professional | | $295.12 | $426.58 | $977.24 |