- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $645.65 / $2,818.38 / $8,317.64
| Facility | | $645.65 | $2,818.38 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $467.74 / $691.83 / $1,513.56
| Professional | | $467.74 | $691.83 | $1,513.56 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $446.68 / $446.68 / $467.74
| Professional | | $446.68 | $446.68 | $467.74 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,456.54 / $6,606.93 / $57,543.99
| Facility | | $6,456.54 | $6,606.93 | $57,543.99 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $691.83 / $707.95 / $1,348.96
| Professional | | $691.83 | $707.95 | $1,348.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $489.78 / $741.31 / $1,258.93
| Professional | | $489.78 | $741.31 | $1,258.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $831.76 / $1,148.15 / $1,445.44
| Professional | | $831.76 | $1,148.15 | $1,445.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $549.54 / $741.31 / $1,202.26
| Professional | | $549.54 | $741.31 | $1,202.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,584.89 / $6,918.31 / $10,964.78
| Facility | | $1,584.89 | $6,918.31 | $10,964.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $489.78 / $501.19 / $575.44
| Professional | | $489.78 | $501.19 | $575.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $645.65 / $1,584.89 / $7,762.47
| Facility | | $645.65 | $1,584.89 | $7,762.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $467.74 / $707.95 / $1,348.96
| Professional | | $467.74 | $707.95 | $1,348.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $776.25 / $1,047.13 / $1,698.24
| Professional | | $776.25 | $1,047.13 | $1,698.24 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $416.87 / $467.74 / $676.08
| Facility | | $416.87 | $467.74 | $676.08 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $416.87 / $478.63 / $707.95
| Professional | | $416.87 | $478.63 | $707.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,137.96 / $4,570.88 / $10,471.29
| Facility | | $2,137.96 | $4,570.88 | $10,471.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $467.74 / $724.44 / $1,258.93
| Professional | | $467.74 | $724.44 | $1,258.93 |