- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $870.96 / $3,548.13 / $12,022.64
| Facility | | $870.96 | $3,548.13 | $12,022.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $346.74 / $1,288.25 / $1,995.26
| Professional | | $346.74 | $1,288.25 | $1,995.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $309.03 / $776.25 / $1,445.44
| Professional | | $309.03 | $776.25 | $1,445.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $309.03 / $309.03 / $309.03
| Facility | | $309.03 | $309.03 | $309.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,090.30 / $3,090.30 / $3,090.30
| Facility | | $3,090.30 | $3,090.30 | $3,090.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $389.05 / $812.83 / $2,754.23
| Professional | | $389.05 | $812.83 | $2,754.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $54.95 / $56.23 / $12,302.69
| Facility | | $54.95 | $56.23 | $12,302.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8,709.64 / $10,471.29 / $10,471.29
| Professional | | $8,709.64 | $10,471.29 | $10,471.29 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $416.87 / $1,737.80 / $5,248.07
| Facility | | $416.87 | $1,737.80 | $5,248.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $380.19 / $1,348.96 / $2,238.72
| Professional | | $380.19 | $1,348.96 | $2,238.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $281.84
| Professional | | $32.36 | $33.11 | $281.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,122.02 / $1,230.27 / $4,466.84
| Professional | | $1,122.02 | $1,230.27 | $4,466.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $354.81 / $1,148.15 / $2,754.23
| Facility | | $354.81 | $1,148.15 | $2,754.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $380.19 / $870.96 / $2,754.23
| Professional | | $380.19 | $870.96 | $2,754.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,737.80 / $4,786.30 / $9,120.11
| Facility | | $1,737.80 | $4,786.30 | $9,120.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $323.59 / $1,023.29 / $2,511.89
| Professional | | $323.59 | $1,023.29 | $2,511.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,148.15 / $1,148.15 / $1,202.26
| Professional | | $1,148.15 | $1,148.15 | $1,202.26 |