- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $213.80 / $1,047.13 / $3,467.37
| Facility | | $213.80 | $1,047.13 | $3,467.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $177.83 / $446.68 / $831.76
| Professional | | $177.83 | $446.68 | $831.76 |
- 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
- $295.12 / $741.31 / $1,995.26
| Professional | | $295.12 | $741.31 | $1,995.26 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $436.52 / $1,122.02 / $3,019.95
| Professional | 50 | $436.52 | $1,122.02 | $3,019.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,412.54 / $1,659.59 / $2,630.27
| Facility | | $1,412.54 | $1,659.59 | $2,630.27 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $251.19 / $630.96 / $1,862.09
| Professional | | $251.19 | $630.96 | $1,862.09 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $213.80 / $2,398.83 / $4,265.80
| Facility | | $213.80 | $2,398.83 | $4,265.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $380.19 / $588.84 / $1,513.56
| Professional | | $380.19 | $588.84 | $1,513.56 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $575.44 / $870.96 / $2,290.87
| Professional | 50 | $575.44 | $870.96 | $2,290.87 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $213.80 / $4,570.88 / $8,709.64
| Facility | | $213.80 | $4,570.88 | $8,709.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $501.19 / $912.01 / $2,290.87
| Professional | | $501.19 | $912.01 | $2,290.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $70.79
| Professional | | $32.36 | $33.11 | $70.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,248.07 / $5,754.40 / $7,762.47
| Facility | | $5,248.07 | $5,754.40 | $7,762.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $512.86 / $758.58 / $1,737.80
| Professional | | $512.86 | $758.58 | $1,737.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $302.00 / $676.08 / $1,778.28
| Professional | | $302.00 | $676.08 | $1,778.28 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,165.95 / $6,165.95 / $9,120.11
| Facility | | $6,165.95 | $6,165.95 | $9,120.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $269.15 / $933.25 / $3,630.78
| Professional | | $269.15 | $933.25 | $3,630.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $426.58 / $426.58 / $1,318.26
| Professional | | $426.58 | $426.58 | $1,318.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $954.99 / $1,230.27 / $3,162.28
| Professional | | $954.99 | $1,230.27 | $3,162.28 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,897.79 / $7,585.78 / $9,120.11
| Facility | | $4,897.79 | $7,585.78 | $9,120.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $223.87 / $645.65 / $1,905.46
| Professional | | $223.87 | $645.65 | $1,905.46 |