- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $331.13 / $6,025.60 / $17,378.01
| Facility | | $331.13 | $6,025.60 | $17,378.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $177.83 / $407.38 / $1,513.56
| Professional | | $177.83 | $407.38 | $1,513.56 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $173.78 / $194.98 / $331.13
| Professional | | $173.78 | $194.98 | $331.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,165.95 / $8,709.64 / $17,378.01
| Facility | | $6,165.95 | $8,709.64 | $17,378.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $269.15 / $457.09 / $851.14
| Professional | | $269.15 | $457.09 | $851.14 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $630.96 / $758.58 / $4,466.84
| Facility | | $630.96 | $758.58 | $4,466.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $257.04 / $501.19 / $870.96
| Professional | | $257.04 | $501.19 | $870.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $398.11 / $707.95 / $2,884.03
| Facility | | $398.11 | $707.95 | $2,884.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $380.19 / $691.83 / $1,584.89
| Professional | | $380.19 | $691.83 | $1,584.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $91.20
| Professional | | $32.36 | $33.11 | $91.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $549.54 / $741.31 / $1,096.48
| Facility | | $549.54 | $741.31 | $1,096.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $407.38 / $407.38 / $977.24
| Facility | | $407.38 | $407.38 | $977.24 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $239.88 / $407.38 / $724.44
| Professional | | $239.88 | $407.38 | $724.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,888.44 / $8,912.51 / $17,378.01
| Facility | | $5,888.44 | $8,912.51 | $17,378.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $257.04 / $446.68 / $812.83
| Professional | | $257.04 | $446.68 | $812.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,137.96 / $10,232.93 / $18,620.87
| Facility | | $2,137.96 | $10,232.93 | $18,620.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $371.54 / $645.65 / $1,047.13
| Professional | | $371.54 | $645.65 | $1,047.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $173.78 / $331.13 / $426.58
| Professional | | $173.78 | $331.13 | $426.58 |