- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $363.08 / $2,290.87 / $8,709.64
| Facility | | $363.08 | $2,290.87 | $8,709.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $144.54 / $501.19 / $1,412.54
| Professional | | $144.54 | $501.19 | $1,412.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $134.90 / $134.90 / $134.90
| Professional | | $134.90 | $134.90 | $134.90 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,570.40 / $3,467.37 / $19,952.62
| Facility | | $2,570.40 | $3,467.37 | $19,952.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,011.87 / $8,511.38 / $77,624.71
| Facility | | $5,011.87 | $8,511.38 | $77,624.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $645.65 / $1,096.48 / $1,445.44
| Professional | | $645.65 | $1,096.48 | $1,445.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $173.78 / $309.03 / $1,513.56
| Professional | | $173.78 | $309.03 | $1,513.56 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,288.25 / $1,288.25 / $1,348.96
| Professional | | $1,288.25 | $1,288.25 | $1,348.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $181.97 / $1,071.52 / $1,819.70
| Professional | | $181.97 | $1,071.52 | $1,819.70 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $660.69 / $2,818.38 / $16,982.44
| Facility | | $660.69 | $2,818.38 | $16,982.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $177.83 / $194.98 / $977.24
| Professional | | $177.83 | $194.98 | $977.24 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,137.96 / $3,019.95 / $19,054.61
| Facility | | $2,137.96 | $3,019.95 | $19,054.61 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $426.58 / $1,584.89 / $6,165.95
| Facility | | $426.58 | $1,584.89 | $6,165.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $165.96 / $741.31 / $1,698.24
| Professional | | $165.96 | $741.31 | $1,698.24 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $204.17 / $213.80 / $2,089.30
| Professional | | $204.17 | $213.80 | $2,089.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $186.21 / $186.21 / $912.01
| Facility | | $186.21 | $186.21 | $912.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $186.21 / $186.21 / $912.01
| Professional | | $186.21 | $186.21 | $912.01 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $162.18 / $575.44 / $4,466.84
| Facility | | $162.18 | $575.44 | $4,466.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $151.36 / $407.38 / $1,513.56
| Professional | | $151.36 | $407.38 | $1,513.56 |