- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $549.54 / $2,344.23 / $5,370.32
| Facility | | $549.54 | $2,344.23 | $5,370.32 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $354.81 / $549.54 / $1,288.25
| Professional | | $354.81 | $549.54 | $1,288.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $912.01 / $4,897.79 / $28,840.32
| Facility | | $912.01 | $4,897.79 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- AS
- Typical Low / Median / Typical High
- $933.25 / $933.25 / $933.25
| Facility | AS | $933.25 | $933.25 | $933.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $416.87 / $707.95 / $1,949.84
| Professional | | $416.87 | $707.95 | $1,949.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $467.74 / $467.74 / $1,071.52
| Facility | | $467.74 | $467.74 | $1,071.52 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $467.74 / $794.33 / $1,230.27
| Professional | | $467.74 | $794.33 | $1,230.27 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $389.05 / $676.08 / $1,479.11
| Professional | | $389.05 | $676.08 | $1,479.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $380.19 / $537.03 / $3,467.37
| Facility | | $380.19 | $537.03 | $3,467.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $660.69 / $812.83 / $1,047.13
| Professional | | $660.69 | $812.83 | $1,047.13 |
- 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
- $446.68 / $776.25 / $1,513.56
| Professional | | $446.68 | $776.25 | $1,513.56 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,090.30 / $3,090.30 / $3,235.94
| Facility | | $3,090.30 | $3,090.30 | $3,235.94 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $64.57 / $288.40 / $794.33
| Professional | | $64.57 | $288.40 | $794.33 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $912.01 / $4,897.79 / $28,840.32
| Facility | | $912.01 | $4,897.79 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- AS
- Typical Low / Median / Typical High
- $933.25 / $933.25 / $933.25
| Facility | AS | $933.25 | $933.25 | $933.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $416.87 / $707.95 / $1,949.84
| Professional | | $416.87 | $707.95 | $1,949.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,862.09 / $3,981.07 / $9,772.37
| Facility | | $1,862.09 | $3,981.07 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $436.52 / $741.31 / $1,621.81
| Professional | | $436.52 | $741.31 | $1,621.81 |