- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $354.81 / $1,548.82 / $4,265.80
| Facility | | $354.81 | $1,548.82 | $4,265.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $338.84 / $512.86 / $1,071.52
| Professional | | $338.84 | $512.86 | $1,071.52 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,011.87 / $7,943.28 / $13,182.57
| Facility | | $5,011.87 | $7,943.28 | $13,182.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $489.78 / $758.58 / $1,949.84
| Professional | | $489.78 | $758.58 | $1,949.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,412.54 / $1,659.59 / $2,754.23
| Facility | | $1,412.54 | $1,659.59 | $2,754.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $549.54 / $1,258.93 / $2,454.71
| Professional | | $549.54 | $1,258.93 | $2,454.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $363.08 / $707.95 / $3,548.13
| Facility | | $363.08 | $707.95 | $3,548.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $676.08 / $977.24 / $1,479.11
| Professional | | $676.08 | $977.24 | $1,479.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $363.08 / $724.44 / $7,943.28
| Facility | | $363.08 | $724.44 | $7,943.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $524.81 / $1,047.13 / $3,890.45
| Professional | | $524.81 | $1,047.13 | $3,890.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $478.63
| Professional | | $32.36 | $33.11 | $478.63 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $724.44 / $5,754.40 / $7,762.47
| Facility | | $724.44 | $5,754.40 | $7,762.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $660.69 / $1,202.26 / $1,621.81
| Professional | | $660.69 | $1,202.26 | $1,621.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $676.08 / $1,148.15 / $1,819.70
| Professional | | $676.08 | $1,148.15 | $1,819.70 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,025.60 / $8,912.51 / $8,912.51
| Facility | | $6,025.60 | $8,912.51 | $8,912.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $660.69 / $2,570.40 / $3,801.89
| Professional | | $660.69 | $2,570.40 | $3,801.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,174.90 / $1,174.90 / $1,737.80
| Professional | | $1,174.90 | $1,174.90 | $1,737.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $660.69 / $2,344.23 / $3,388.44
| Professional | | $660.69 | $2,344.23 | $3,388.44 |
- 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 / $977.24 / $2,187.76
| Professional | | $89.13 | $977.24 | $2,187.76 |