- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $758.58 / $2,344.23 / $8,128.31
| Facility | | $758.58 | $2,344.23 | $8,128.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $457.09 / $549.54 / $977.24
| Professional | | $457.09 | $549.54 | $977.24 |
- 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
- $549.54 / $562.34 / $977.24
| Professional | | $549.54 | $562.34 | $977.24 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $457.09 / $616.60 / $1,023.29
| Professional | | $457.09 | $616.60 | $1,023.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $724.44 / $977.24 / $1,258.93
| Professional | | $724.44 | $977.24 | $1,258.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $501.19 / $741.31 / $1,071.52
| Professional | | $501.19 | $741.31 | $1,071.52 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $524.81 / $2,884.03 / $7,762.47
| Facility | | $524.81 | $2,884.03 | $7,762.47 |
- Facility/Professional
- Facility
- Modifier
- 54
- Typical Low / Median / Typical High
- $794.33 / $794.33 / $794.33
| Facility | 54 | $794.33 | $794.33 | $794.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $524.81 / $549.54 / $870.96
| Professional | | $524.81 | $549.54 | $870.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $616.60 / $1,819.70 / $7,079.46
| Facility | | $616.60 | $1,819.70 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $457.09 / $602.56 / $1,174.90
| Professional | | $457.09 | $602.56 | $1,174.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $660.69 / $891.25 / $1,230.27
| Professional | | $660.69 | $891.25 | $1,230.27 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $309.03 / $489.78 / $524.81
| Facility | | $309.03 | $489.78 | $524.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $309.03 / $489.78 / $524.81
| Professional | | $309.03 | $489.78 | $524.81 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,096.48 / $2,884.03 / $5,623.41
| Facility | | $1,096.48 | $2,884.03 | $5,623.41 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $436.52 / $588.84 / $1,047.13
| Professional | | $436.52 | $588.84 | $1,047.13 |