- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $398.11 / $851.14 / $1,905.46
| Facility | | $398.11 | $851.14 | $1,905.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $380.19 / $446.68 / $933.25
| Professional | | $380.19 | $446.68 | $933.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,311.31 / $4,786.30 / $7,585.78
| Facility | | $3,311.31 | $4,786.30 | $7,585.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $416.87 / $794.33 / $1,995.26
| Professional | | $416.87 | $794.33 | $1,995.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,202.26 / $1,380.38 / $2,238.72
| Facility | | $1,202.26 | $1,380.38 | $2,238.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $489.78 / $1,047.13 / $2,089.30
| Professional | | $489.78 | $1,047.13 | $2,089.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $371.54 / $616.60 / $3,162.28
| Facility | | $371.54 | $616.60 | $3,162.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $758.58 / $1,023.29 / $1,288.25
| Professional | | $758.58 | $1,023.29 | $1,288.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $371.54 / $660.69 / $3,981.07
| Facility | | $371.54 | $660.69 | $3,981.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $446.68 / $891.25 / $3,311.31
| Professional | | $446.68 | $891.25 | $3,311.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $512.86
| Professional | | $32.36 | $33.11 | $512.86 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $776.25 / $2,951.21 / $3,235.94
| Facility | | $776.25 | $2,951.21 | $3,235.94 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $562.34 / $1,023.29 / $1,778.28
| Professional | | $562.34 | $1,023.29 | $1,778.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $724.44 / $1,148.15 / $1,621.81
| Professional | | $724.44 | $1,148.15 | $1,621.81 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,737.80 / $3,235.94 / $4,786.30
| Facility | | $1,737.80 | $3,235.94 | $4,786.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $660.69 / $2,089.30 / $3,235.94
| Professional | | $660.69 | $2,089.30 | $3,235.94 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,318.26 / $1,318.26 / $1,412.54
| Professional | | $1,318.26 | $1,318.26 | $1,412.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $478.63 / $2,630.27 / $2,884.03
| Professional | | $478.63 | $2,630.27 | $2,884.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,238.72 / $2,818.38 / $5,128.61
| Facility | | $2,238.72 | $2,818.38 | $5,128.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $407.38 / $616.60 / $1,698.24
| Professional | | $407.38 | $616.60 | $1,698.24 |