- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $645.65 / $5,128.61 / $15,848.93
| Facility | | $645.65 | $5,128.61 | $15,848.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $467.74 / $2,238.72 / $5,011.87
| Professional | | $467.74 | $2,238.72 | $5,011.87 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,011.87 / $10,964.78 / $19,054.61
| Facility | | $5,011.87 | $10,964.78 | $19,054.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,137.96 / $2,691.53 / $6,165.95
| Professional | | $2,137.96 | $2,691.53 | $6,165.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $630.96 / $1,905.46 / $37,153.52
| Facility | | $630.96 | $1,905.46 | $37,153.52 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $630.96 / $630.96 / $3,467.37
| Professional | | $630.96 | $630.96 | $3,467.37 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $741.31 / $20,417.38 / $50,118.72
| Facility | | $741.31 | $20,417.38 | $50,118.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $478.63 / $1,659.59 / $5,888.44
| Professional | | $478.63 | $1,659.59 | $5,888.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $436.52 / $588.84 / $1,479.11
| Facility | | $436.52 | $588.84 | $1,479.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,290.87 / $3,467.37 / $4,786.30
| Professional | | $2,290.87 | $3,467.37 | $4,786.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,698.24 / $2,511.89 / $4,073.80
| Professional | | $1,698.24 | $2,511.89 | $4,073.80 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9,120.11 / $9,120.11 / $9,120.11
| Facility | | $9,120.11 | $9,120.11 | $9,120.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $512.86 / $50,118.72 / $75,857.76
| Facility | | $512.86 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,630.27 / $3,235.94 / $3,630.78
| Professional | | $2,630.27 | $3,235.94 | $3,630.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,691.53 / $7,762.47 / $19,952.62
| Facility | | $2,691.53 | $7,762.47 | $19,952.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $416.87 / $2,187.76 / $5,128.61
| Professional | | $416.87 | $2,187.76 | $5,128.61 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $354.81 / $549.54 / $758.58
| Facility | | $354.81 | $549.54 | $758.58 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $724.44 / $2,137.96 / $3,801.89
| Professional | | $724.44 | $2,137.96 | $3,801.89 |