- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,290.87 / $6,456.54 / $17,782.79
| Facility | | $2,290.87 | $6,456.54 | $17,782.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $162.18 / $512.86 / $1,479.11
| Professional | | $162.18 | $512.86 | $1,479.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,630.78 / $6,165.95 / $13,489.63
| Facility | | $3,630.78 | $6,165.95 | $13,489.63 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $269.15 / $1,202.26 / $2,344.23
| Professional | | $269.15 | $1,202.26 | $2,344.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $83.18 / $5,754.40 / $10,715.19
| Facility | | $83.18 | $5,754.40 | $10,715.19 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $645.65 / $1,174.90 / $2,570.40
| Professional | | $645.65 | $1,174.90 | $2,570.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $173.78 / $446.68 / $1,380.38
| Professional | | $173.78 | $446.68 | $1,380.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $144.54 / $707.95 / $1,071.52
| Professional | | $144.54 | $707.95 | $1,071.52 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $138.04 / $436.52 / $831.76
| Professional | | $138.04 | $436.52 | $831.76 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $54.95 / $56.23 / $2,630.27
| Facility | | $54.95 | $56.23 | $2,630.27 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4,786.30 / $4,786.30 / $5,495.41
| Professional | | $4,786.30 | $4,786.30 | $5,495.41 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $389.05 / $389.05 / $645.65
| Professional | | $389.05 | $389.05 | $645.65 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $169.82 / $512.86 / $1,202.26
| Facility | | $169.82 | $512.86 | $1,202.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $173.78 / $446.68 / $1,348.96
| Professional | | $173.78 | $446.68 | $1,348.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $524.81 / $524.81 / $1,995.26
| Professional | | $524.81 | $524.81 | $1,995.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $131.83 / $1,071.52 / $1,621.81
| Professional | | $131.83 | $1,071.52 | $1,621.81 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $575.44 / $1,584.89 / $6,760.83
| Facility | | $575.44 | $1,584.89 | $6,760.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $154.88 / $489.78 / $1,412.54
| Professional | | $154.88 | $489.78 | $1,412.54 |