- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $575.44 / $3,388.44 / $18,620.87
| Facility | | $575.44 | $3,388.44 | $18,620.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $323.59 / $977.24 / $2,511.89
| Professional | | $323.59 | $977.24 | $2,511.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,165.95 / $8,511.38 / $17,378.01
| Facility | | $6,165.95 | $8,511.38 | $17,378.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $426.58 / $954.99 / $2,951.21
| Professional | | $426.58 | $954.99 | $2,951.21 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,801.89 / $3,801.89 / $3,801.89
| Facility | | $3,801.89 | $3,801.89 | $3,801.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $426.58 / $933.25 / $3,630.78
| Professional | | $426.58 | $933.25 | $3,630.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $549.54 / $2,137.96 / $12,022.64
| Facility | | $549.54 | $2,137.96 | $12,022.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $562.34 / $1,479.11 / $3,467.37
| Professional | | $562.34 | $1,479.11 | $3,467.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $194.98
| Professional | | $32.36 | $33.11 | $194.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,479.11 / $2,344.23 / $2,630.27
| Facility | | $1,479.11 | $2,344.23 | $2,630.27 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,698.24 / $1,819.70 / $1,819.70
| Facility | | $1,698.24 | $1,819.70 | $1,819.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $426.58 / $1,698.24 / $3,019.95
| Professional | | $426.58 | $1,698.24 | $3,019.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,888.44 / $8,912.51 / $17,378.01
| Facility | | $5,888.44 | $8,912.51 | $17,378.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $501.19 / $954.99 / $2,884.03
| Professional | | $501.19 | $954.99 | $2,884.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,884.03 / $10,232.93 / $18,197.01
| Facility | | $2,884.03 | $10,232.93 | $18,197.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $416.87 / $1,348.96 / $2,884.03
| Professional | | $416.87 | $1,348.96 | $2,884.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $338.84 / $602.56 / $3,019.95
| Professional | | $338.84 | $602.56 | $3,019.95 |