- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $630.96 / $8,128.31 / $19,498.45
| Facility | | $630.96 | $8,128.31 | $19,498.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $380.19 / $457.09 / $2,454.71
| Professional | | $380.19 | $457.09 | $2,454.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $141,253.75 / $154,881.66 / $169,824.37
| Facility | | $141,253.75 | $154,881.66 | $169,824.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $346.74 / $457.09 / $645.65
| Professional | | $346.74 | $457.09 | $645.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $380.19 / $13,489.63 / $17,782.79
| Professional | | $380.19 | $13,489.63 | $17,782.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $363.08 / $549.54 / $776.25
| Professional | | $363.08 | $549.54 | $776.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $309.03 / $363.08 / $457.09
| Professional | | $309.03 | $363.08 | $457.09 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $630.96 / $794.33 / $851.14
| Professional | | $630.96 | $794.33 | $851.14 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $389.05 / $588.84 / $851.14
| Facility | | $389.05 | $588.84 | $851.14 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $338.84 / $588.84 / $39,810.72
| Facility | | $338.84 | $588.84 | $39,810.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $338.84 / $588.84 / $39,810.72
| Professional | | $338.84 | $588.84 | $39,810.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $22,908.68 / $74,131.02 / $131,825.67
| Facility | | $22,908.68 | $74,131.02 | $131,825.67 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $346.74 / $588.84 / $831.76
| Professional | | $346.74 | $588.84 | $831.76 |