- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $562.34 / $6,760.83 / $14,791.08
| Facility | | $562.34 | $6,760.83 | $14,791.08 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $323.59 / $3,235.94 / $7,762.47
| Professional | | $323.59 | $3,235.94 | $7,762.47 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11,748.98 / $14,791.08 / $15,848.93
| Facility | | $11,748.98 | $14,791.08 | $15,848.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $323.59 / $1,071.52 / $6,456.54
| Professional | | $323.59 | $1,071.52 | $6,456.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $323.59 / $16,595.87 / $22,387.21
| Professional | | $323.59 | $16,595.87 | $22,387.21 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $323.59 / $812.83 / $9,120.11
| Professional | | $323.59 | $812.83 | $9,120.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $269.15 / $5,623.41 / $7,079.46
| Professional | | $269.15 | $5,623.41 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11,748.98 / $11,748.98 / $11,748.98
| Professional | | $11,748.98 | $11,748.98 | $11,748.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $363.08 / $4,677.35 / $9,772.37
| Facility | | $363.08 | $4,677.35 | $9,772.37 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $295.12 / $416.87 / $19,952.62
| Facility | | $295.12 | $416.87 | $19,952.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4,570.88 / $7,244.36 / $20,892.96
| Professional | | $4,570.88 | $7,244.36 | $20,892.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10,715.19 / $17,782.79 / $31,622.78
| Facility | | $10,715.19 | $17,782.79 | $31,622.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $302.00 / $3,388.44 / $9,772.37
| Professional | | $302.00 | $3,388.44 | $9,772.37 |