- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $562.34 / $2,570.40 / $7,585.78
| Facility | | $562.34 | $2,570.40 | $7,585.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $229.09 / $363.08 / $588.84
| Professional | | $229.09 | $363.08 | $588.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $114.82 / $190.55 / $380.19
| Professional | | $114.82 | $190.55 | $380.19 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $251.19 / $371.54 / $1,621.81
| Facility | | $251.19 | $371.54 | $1,621.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $223.87 / $338.84 / $501.19
| Professional | | $223.87 | $338.84 | $501.19 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $79.43 / $223.87 / $223.87
| Facility | | $79.43 | $223.87 | $223.87 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $407.38 / $407.38 / $407.38
| Facility | | $407.38 | $407.38 | $407.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $257.04 / $416.87 / $691.83
| Professional | | $257.04 | $416.87 | $691.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,290.87 / $13,489.63 / $13,489.63
| Facility | | $2,290.87 | $13,489.63 | $13,489.63 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,691.53 / $3,090.30 / $3,090.30
| Professional | | $2,691.53 | $3,090.30 | $3,090.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $251.19 / $457.09 / $2,884.03
| Facility | | $251.19 | $457.09 | $2,884.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $234.42 / $389.05 / $691.83
| Professional | | $234.42 | $389.05 | $691.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $194.98 / $316.23
| Professional | | $32.36 | $194.98 | $316.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $436.52 / $436.52 / $436.52
| Professional | | $436.52 | $436.52 | $436.52 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $239.88 / $398.11 / $676.08
| Facility | | $239.88 | $398.11 | $676.08 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $251.19 / $416.87 / $691.83
| Professional | | $251.19 | $416.87 | $691.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,288.25 / $3,311.31 / $7,244.36
| Facility | | $1,288.25 | $3,311.31 | $7,244.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $213.80 / $338.84 / $549.54
| Professional | | $213.80 | $338.84 | $549.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $363.08 / $371.54 / $380.19
| Professional | | $363.08 | $371.54 | $380.19 |