- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $588.84 / $5,248.07 / $14,125.38
| Facility | | $588.84 | $5,248.07 | $14,125.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $446.68 / $1,479.11 / $3,890.45
| Professional | | $446.68 | $1,479.11 | $3,890.45 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,677.35 / $9,772.37 / $18,620.87
| Facility | | $4,677.35 | $9,772.37 | $18,620.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,584.89 / $2,089.30 / $5,495.41
| Professional | | $1,584.89 | $2,089.30 | $5,495.41 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $549.54 / $549.54 / $8,912.51
| Facility | | $549.54 | $549.54 | $8,912.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $549.54 / $549.54 / $2,691.53
| Professional | | $549.54 | $549.54 | $2,691.53 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $34.67 / $4,365.16 / $53,703.18
| Facility | | $34.67 | $4,365.16 | $53,703.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $398.11 / $1,412.54 / $5,128.61
| Professional | | $398.11 | $1,412.54 | $5,128.61 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $407.38 / $741.31 / $1,348.96
| Facility | | $407.38 | $741.31 | $1,348.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,659.59 / $2,511.89 / $3,548.13
| Professional | | $1,659.59 | $2,511.89 | $3,548.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,479.11 / $2,041.74 / $3,019.95
| Professional | | $1,479.11 | $2,041.74 | $3,019.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,897.79 / $18,620.87 / $36,307.81
| Facility | | $4,897.79 | $18,620.87 | $36,307.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $354.81 / $478.63 / $478.63
| Professional | | $354.81 | $478.63 | $478.63 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $457.09 / $50,118.72 / $75,857.76
| Facility | | $457.09 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,089.30 / $2,570.40 / $2,884.03
| Professional | | $2,089.30 | $2,570.40 | $2,884.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,454.71 / $6,309.57 / $16,595.87
| Facility | | $2,454.71 | $6,309.57 | $16,595.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $389.05 / $1,737.80 / $3,981.07
| Professional | | $389.05 | $1,737.80 | $3,981.07 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $309.03 / $489.78 / $1,621.81
| Facility | | $309.03 | $489.78 | $1,621.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,148.15 / $1,862.09 / $3,467.37
| Professional | | $1,148.15 | $1,862.09 | $3,467.37 |