- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,258.93 / $2,630.27 / $17,782.79
| Facility | | $1,258.93 | $2,630.27 | $17,782.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $81.28 / $295.12 / $9,120.11
| Professional | | $81.28 | $295.12 | $9,120.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $56.23 / $6,165.95 / $20,417.38
| Facility | | $56.23 | $6,165.95 | $20,417.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $91.20 / $3,467.37 / $12,589.25
| Professional | | $91.20 | $3,467.37 | $12,589.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $97.72 / $97.72 / $229.09
| Facility | | $97.72 | $97.72 | $229.09 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $112.20 / $338.84 / $8,912.51
| Professional | | $112.20 | $338.84 | $8,912.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $120.23 / $645.65 / $12,302.69
| Professional | | $120.23 | $645.65 | $12,302.69 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $83.18 / $112.20 / $4,786.30
| Facility | | $83.18 | $112.20 | $4,786.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4,897.79 / $5,888.44 / $8,709.64
| Professional | | $4,897.79 | $5,888.44 | $8,709.64 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,467.37 / $6,918.31 / $20,417.38
| Facility | | $3,467.37 | $6,918.31 | $20,417.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $91.20 / $4,168.69 / $10,471.29
| Professional | | $91.20 | $4,168.69 | $10,471.29 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,023.29 / $2,754.23 / $17,378.01
| Facility | | $1,023.29 | $2,754.23 | $17,378.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $181.97 / $181.97 / $181.97
| Professional | | $181.97 | $181.97 | $181.97 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $56.23 / $6,165.95 / $20,417.38
| Facility | | $56.23 | $6,165.95 | $20,417.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $91.20 / $3,467.37 / $12,589.25
| Professional | | $91.20 | $3,467.37 | $12,589.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,235.94 / $6,918.31 / $25,703.96
| Facility | | $3,235.94 | $6,918.31 | $25,703.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $107.15 / $4,897.79 / $11,748.98
| Professional | | $107.15 | $4,897.79 | $11,748.98 |