- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $346.74 / $3,311.31 / $11,481.54
| Facility | | $346.74 | $3,311.31 | $11,481.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $208.93 / $707.95 / $1,862.09
| Professional | | $208.93 | $707.95 | $1,862.09 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,388.44 / $5,495.41 / $12,882.50
| Facility | | $3,388.44 | $5,495.41 | $12,882.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $912.01 / $1,096.48 / $2,570.40
| Professional | | $912.01 | $1,096.48 | $2,570.40 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $295.12 / $295.12 / $8,912.51
| Facility | | $295.12 | $295.12 | $8,912.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $295.12 / $295.12 / $1,584.89
| Professional | | $295.12 | $295.12 | $1,584.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $34.67 / $363.08 / $50,118.72
| Facility | | $34.67 | $363.08 | $50,118.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $234.42 / $954.99 / $3,162.28
| Professional | | $234.42 | $954.99 | $3,162.28 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $165.96 / $245.47 / $676.08
| Facility | | $165.96 | $245.47 | $676.08 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,096.48 / $1,659.59 / $2,187.76
| Professional | | $1,096.48 | $1,659.59 | $2,187.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $851.14 / $1,380.38 / $2,344.23
| Professional | | $851.14 | $1,380.38 | $2,344.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $263.03 / $50,118.72 / $75,857.76
| Facility | | $263.03 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $398.11 / $1,318.26 / $2,570.40
| Professional | | $398.11 | $1,318.26 | $2,570.40 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,348.96 / $2,511.89 / $4,897.79
| Facility | | $1,348.96 | $2,511.89 | $4,897.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $234.42 / $1,318.26 / $2,089.30
| Professional | | $234.42 | $1,318.26 | $2,089.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $169.82 / $263.03 / $912.01
| Facility | | $169.82 | $263.03 | $912.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $691.83 / $1,202.26 / $2,137.96
| Professional | | $691.83 | $1,202.26 | $2,137.96 |