- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,187.76 / $6,456.54 / $16,982.44
| Facility | | $2,187.76 | $6,456.54 | $16,982.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $117.49 / $218.78 / $676.08
| Professional | | $117.49 | $218.78 | $676.08 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,570.40 / $4,570.88 / $12,882.50
| Facility | | $2,570.40 | $4,570.88 | $12,882.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $147.91 / $257.04 / $588.84
| Professional | | $147.91 | $257.04 | $588.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $85.11 / $4,786.30 / $9,332.54
| Facility | | $85.11 | $4,786.30 | $9,332.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $131.83 / $251.19 / $537.03
| Professional | | $131.83 | $251.19 | $537.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,041.74 / $2,041.74 / $2,398.83
| Facility | | $2,041.74 | $2,041.74 | $2,398.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $128.82 / $229.09 / $537.03
| Professional | | $128.82 | $229.09 | $537.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $75.86 / $120.23 / $346.74
| Professional | | $75.86 | $120.23 | $346.74 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $107.15 / $229.09 / $416.87
| Professional | | $107.15 | $229.09 | $416.87 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9,549.93 / $28,840.32 / $28,840.32
| Facility | | $9,549.93 | $28,840.32 | $28,840.32 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,548.82 / $1,819.70 / $1,819.70
| Professional | | $1,548.82 | $1,819.70 | $1,819.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $181.97 / $181.97 / $302.00
| Professional | | $181.97 | $181.97 | $302.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $128.82 / $239.88 / $407.38
| Facility | | $128.82 | $239.88 | $407.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $125.89 / $229.09 / $478.63
| Professional | | $125.89 | $229.09 | $478.63 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $389.05 / $389.05 / $707.95
| Professional | | $389.05 | $389.05 | $707.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $95.50 / $128.82 / $234.42
| Professional | | $95.50 | $128.82 | $234.42 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,187.76 / $4,365.16 / $9,549.93
| Facility | | $2,187.76 | $4,365.16 | $9,549.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $107.15 / $194.98 / $467.74
| Professional | | $107.15 | $194.98 | $467.74 |