- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,318.26 / $5,623.41 / $13,182.57
| Facility | | $1,318.26 | $5,623.41 | $13,182.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $141.25 / $549.54 / $3,090.30
| Professional | | $141.25 | $549.54 | $3,090.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $275.42 / $331.13 / $346.74
| Professional | | $275.42 | $331.13 | $346.74 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,511.89 / $4,570.88 / $12,882.50
| Facility | | $2,511.89 | $4,570.88 | $12,882.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $208.93 / $1,348.96 / $2,884.03
| Professional | | $208.93 | $1,348.96 | $2,884.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $85.11 / $1,412.54 / $3,162.28
| Facility | | $85.11 | $1,412.54 | $3,162.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $144.54 / $676.08 / $2,238.72
| Professional | | $144.54 | $676.08 | $2,238.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $891.25 / $891.25 / $1,047.13
| Facility | | $891.25 | $891.25 | $1,047.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $169.82 / $616.60 / $1,905.46
| Professional | | $169.82 | $616.60 | $1,905.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $141.25 / $870.96 / $1,318.26
| Professional | | $141.25 | $870.96 | $1,318.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $131.83 / $660.69 / $1,621.81
| Professional | | $131.83 | $660.69 | $1,621.81 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $54.95 / $56.23 / $4,168.69
| Facility | | $54.95 | $56.23 | $4,168.69 |
- Facility/Professional
- Facility
- Modifier
- 53
- Typical Low / Median / Typical High
- $831.76 / $831.76 / $831.76
| Facility | 53 | $831.76 | $831.76 | $831.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5,888.44 / $6,918.31 / $6,918.31
| Professional | | $5,888.44 | $6,918.31 | $6,918.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $691.83 / $691.83 / $1,148.15
| Professional | | $691.83 | $691.83 | $1,148.15 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $154.88 / $831.76 / $1,548.82
| Facility | | $154.88 | $831.76 | $1,548.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $162.18 / $457.09 / $1,862.09
| Professional | | $162.18 | $457.09 | $1,862.09 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $128.82 / $912.01 / $1,479.11
| Professional | | $128.82 | $912.01 | $1,479.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,238.72 / $4,365.16 / $9,772.37
| Facility | | $2,238.72 | $4,365.16 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $141.25 / $794.33 / $1,995.26
| Professional | | $141.25 | $794.33 | $1,995.26 |