- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $446.68 / $933.25 / $14,454.40
| Facility | | $446.68 | $933.25 | $14,454.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $416.87 / $512.86 / $1,778.28
| Professional | | $416.87 | $512.86 | $1,778.28 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,011.87 / $7,943.28 / $12,589.25
| Facility | | $5,011.87 | $7,943.28 | $12,589.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $457.09 / $870.96 / $2,344.23
| Professional | | $457.09 | $870.96 | $2,344.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,174.90 / $1,380.38 / $2,344.23
| Facility | | $1,174.90 | $1,380.38 | $2,344.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $501.19 / $1,862.09 / $2,137.96
| Professional | | $501.19 | $1,862.09 | $2,137.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $446.68 / $977.24 / $5,754.40
| Facility | | $446.68 | $977.24 | $5,754.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $812.83 / $1,096.48 / $1,412.54
| Professional | | $812.83 | $1,096.48 | $1,412.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $457.09 / $1,148.15 / $8,317.64
| Facility | | $457.09 | $1,148.15 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $478.63 / $794.33 / $3,388.44
| Professional | | $478.63 | $794.33 | $3,388.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $70.79
| Professional | | $32.36 | $33.11 | $70.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $933.25 / $5,754.40 / $7,762.47
| Facility | | $933.25 | $5,754.40 | $7,762.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $562.34 / $1,122.02 / $1,905.46
| Professional | | $562.34 | $1,122.02 | $1,905.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $660.69 / $1,000.00 / $1,479.11
| Professional | | $660.69 | $1,000.00 | $1,479.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,454.71 / $4,570.88 / $6,760.83
| Facility | | $2,454.71 | $4,570.88 | $6,760.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $724.44 / $2,187.76 / $3,311.31
| Professional | | $724.44 | $2,187.76 | $3,311.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,479.11 / $1,479.11 / $1,479.11
| Professional | | $1,479.11 | $1,479.11 | $1,479.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,318.26 / $2,511.89 / $2,884.03
| Professional | | $1,318.26 | $2,511.89 | $2,884.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,786.30 / $7,585.78 / $9,120.11
| Facility | | $4,786.30 | $7,585.78 | $9,120.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $467.74 / $707.95 / $1,862.09
| Professional | | $467.74 | $707.95 | $1,862.09 |