- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,202.26 / $5,495.41 / $15,848.93
| Facility | | $1,202.26 | $5,495.41 | $15,848.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $131.83 / $302.00 / $1,096.48
| Professional | | $131.83 | $302.00 | $1,096.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $144.54 / $162.18 / $588.84
| Professional | | $144.54 | $162.18 | $588.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,511.89 / $4,570.88 / $12,882.50
| Facility | | $2,511.89 | $4,570.88 | $12,882.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $218.78 / $891.25 / $1,621.81
| Professional | | $218.78 | $891.25 | $1,621.81 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $85.11 / $9,549.93 / $20,892.96
| Facility | | $85.11 | $9,549.93 | $20,892.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $158.49 / $549.54 / $1,348.96
| Professional | | $158.49 | $549.54 | $1,348.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $281.84 / $660.69 / $794.33
| Facility | | $281.84 | $660.69 | $794.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $165.96 / $524.81 / $1,258.93
| Professional | | $165.96 | $524.81 | $1,258.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $154.88 / $512.86 / $1,148.15
| Professional | | $154.88 | $512.86 | $1,148.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $141.25 / $630.96 / $1,202.26
| Professional | | $141.25 | $630.96 | $1,202.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $56.23 / $3,162.28 / $3,162.28
| Facility | | $56.23 | $3,162.28 | $3,162.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4,786.30 / $5,754.40 / $5,754.40
| Professional | | $4,786.30 | $5,754.40 | $5,754.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $954.99
| Professional | | $32.36 | $33.11 | $954.99 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $173.78 / $512.86 / $1,258.93
| Facility | | $173.78 | $512.86 | $1,258.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $162.18 / $501.19 / $1,445.44
| Professional | | $162.18 | $501.19 | $1,445.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $549.54 / $549.54 / $2,344.23
| Professional | | $549.54 | $549.54 | $2,344.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $141.25 / $724.44 / $933.25
| Professional | | $141.25 | $724.44 | $933.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,187.76 / $4,265.80 / $9,549.93
| Facility | | $2,187.76 | $4,265.80 | $9,549.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $154.88 / $537.03 / $1,230.27
| Professional | | $154.88 | $537.03 | $1,230.27 |