- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $549.54 / $2,754.23 / $7,943.28
| Facility | | $549.54 | $2,754.23 | $7,943.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $281.84 / $1,258.93 / $2,754.23
| Professional | | $281.84 | $1,258.93 | $2,754.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $478.63 / $478.63 / $478.63
| Facility | | $478.63 | $478.63 | $478.63 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $389.05 / $1,096.48 / $3,311.31
| Professional | | $389.05 | $1,096.48 | $3,311.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $478.63 / $707.95 / $3,090.30
| Professional | | $478.63 | $707.95 | $3,090.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $316.23 / $1,202.26 / $2,951.21
| Facility | | $316.23 | $1,202.26 | $2,951.21 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $446.68 / $1,412.54 / $3,162.28
| Professional | | $446.68 | $1,412.54 | $3,162.28 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,445.44 / $2,344.23 / $2,511.89
| Facility | | $1,445.44 | $2,344.23 | $2,511.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $309.03 / $1,202.26 / $2,818.38
| Facility | | $309.03 | $1,202.26 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $346.74 / $812.83 / $3,311.31
| Professional | | $346.74 | $812.83 | $3,311.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7,762.47 / $10,964.78 / $13,489.63
| Facility | | $7,762.47 | $10,964.78 | $13,489.63 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $11,748.98 / $16,218.10 / $20,417.38
| Facility | 50 | $11,748.98 | $16,218.10 | $20,417.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $537.03 / $1,584.89 / $3,311.31
| Professional | | $537.03 | $1,584.89 | $3,311.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,073.80 / $12,882.50 / $25,118.86
| Facility | | $4,073.80 | $12,882.50 | $25,118.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $363.08 / $1,202.26 / $3,162.28
| Professional | | $363.08 | $1,202.26 | $3,162.28 |