- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $436.52 / $2,818.38 / $5,623.41
| Facility | | $436.52 | $2,818.38 | $5,623.41 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $269.15 / $426.58 / $933.25
| Professional | | $269.15 | $426.58 | $933.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $691.83 / $3,235.94 / $28,840.32
| Facility | | $691.83 | $3,235.94 | $28,840.32 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $323.59 / $549.54 / $1,479.11
| Professional | | $323.59 | $549.54 | $1,479.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $346.74 / $346.74 / $794.33
| Facility | | $346.74 | $346.74 | $794.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $346.74 / $602.56 / $977.24
| Professional | | $346.74 | $602.56 | $977.24 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $309.03 / $524.81 / $1,096.48
| Professional | | $309.03 | $524.81 | $1,096.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $257.04 / $389.05 / $3,311.31
| Facility | | $257.04 | $389.05 | $3,311.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $489.78 / $602.56 / $812.83
| Professional | | $489.78 | $602.56 | $812.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,041.74 / $4,265.80 / $9,772.37
| Facility | | $2,041.74 | $4,265.80 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $331.13 / $575.44 / $1,122.02
| Professional | | $331.13 | $575.44 | $1,122.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $407.38 / $407.38 / $794.33
| Professional | | $407.38 | $407.38 | $794.33 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $691.83 / $3,235.94 / $28,840.32
| Facility | | $691.83 | $3,235.94 | $28,840.32 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $323.59 / $549.54 / $1,479.11
| Professional | | $323.59 | $549.54 | $1,479.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,862.09 / $3,890.45 / $8,709.64
| Facility | | $1,862.09 | $3,890.45 | $8,709.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $331.13 / $575.44 / $1,148.15
| Professional | | $331.13 | $575.44 | $1,148.15 |