- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $380.19 / $1,174.90 / $9,549.93
| Facility | | $380.19 | $1,174.90 | $9,549.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $354.81 / $588.84 / $1,862.09
| Professional | | $354.81 | $588.84 | $1,862.09 |
- 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
- $524.81 / $831.76 / $2,041.74
| Professional | | $524.81 | $831.76 | $2,041.74 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,548.82 / $1,778.28 / $3,019.95
| Facility | | $1,548.82 | $1,778.28 | $3,019.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $549.54 / $1,258.93 / $2,691.53
| Professional | | $549.54 | $1,258.93 | $2,691.53 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $398.11 / $758.58 / $3,548.13
| Facility | | $398.11 | $758.58 | $3,548.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $724.44 / $1,047.13 / $1,584.89
| Professional | | $724.44 | $1,047.13 | $1,584.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $398.11 / $812.83 / $7,943.28
| Facility | | $398.11 | $812.83 | $7,943.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $575.44 / $1,230.27 / $4,265.80
| Professional | | $575.44 | $1,230.27 | $4,265.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $501.19
| Professional | | $32.36 | $33.11 | $501.19 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $758.58 / $5,754.40 / $7,762.47
| Facility | | $758.58 | $5,754.40 | $7,762.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $707.95 / $1,288.25 / $1,778.28
| Professional | | $707.95 | $1,288.25 | $1,778.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $724.44 / $1,230.27 / $1,949.84
| Professional | | $724.44 | $1,230.27 | $1,949.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,235.94 / $6,025.60 / $8,912.51
| Facility | | $3,235.94 | $6,025.60 | $8,912.51 |
- Facility/Professional
- Facility
- Modifier
- AS
- Typical Low / Median / Typical High
- $602.56 / $602.56 / $891.25
| Facility | AS | $602.56 | $602.56 | $891.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $645.65 / $2,818.38 / $4,073.80
| Professional | | $645.65 | $2,818.38 | $4,073.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,258.93 / $1,258.93 / $1,862.09
| Professional | | $1,258.93 | $1,258.93 | $1,862.09 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $891.25 / $2,511.89 / $3,715.35
| Professional | | $891.25 | $2,511.89 | $3,715.35 |
- 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
- $89.13 / $1,174.90 / $2,570.40
| Professional | | $89.13 | $1,174.90 | $2,570.40 |