- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $398.11 / $1,621.81 / $6,456.54
| Facility | | $398.11 | $1,621.81 | $6,456.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $338.84 / $1,230.27 / $2,511.89
| Professional | | $338.84 | $1,230.27 | $2,511.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,011.87 / $8,317.64 / $13,182.57
| Facility | | $5,011.87 | $8,317.64 | $13,182.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $549.54 / $1,778.28 / $5,754.40
| Professional | | $549.54 | $1,778.28 | $5,754.40 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,388.44 / $3,890.45 / $6,309.57
| Facility | | $3,388.44 | $3,890.45 | $6,309.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $575.44 / $1,949.84 / $4,466.84
| Professional | | $575.44 | $1,949.84 | $4,466.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $398.11 / $6,760.83 / $13,489.63
| Facility | | $398.11 | $6,760.83 | $13,489.63 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $741.31 / $1,174.90 / $3,548.13
| Professional | | $741.31 | $1,174.90 | $3,548.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $446.68 / $6,606.93 / $12,302.69
| Facility | | $446.68 | $6,606.93 | $12,302.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,584.89 / $3,388.44 / $7,244.36
| Professional | | $1,584.89 | $3,388.44 | $7,244.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $50.12 / $2,398.83
| Professional | | $32.36 | $50.12 | $2,398.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $724.44 / $8,511.38 / $9,120.11
| Facility | | $724.44 | $8,511.38 | $9,120.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,047.13 / $1,778.28 / $5,623.41
| Professional | | $1,047.13 | $1,778.28 | $5,623.41 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $707.95 / $1,479.11 / $4,168.69
| Professional | | $707.95 | $1,479.11 | $4,168.69 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8,317.64 / $8,317.64 / $12,302.69
| Facility | | $8,317.64 | $8,317.64 | $12,302.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $549.54 / $2,691.53 / $8,709.64
| Professional | | $549.54 | $2,691.53 | $8,709.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,659.59 / $1,659.59 / $6,918.31
| Professional | | $1,659.59 | $1,659.59 | $6,918.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,862.09 / $6,456.54 / $8,709.64
| Professional | | $1,862.09 | $6,456.54 | $8,709.64 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,456.54 / $10,232.93 / $12,022.64
| Facility | | $6,456.54 | $10,232.93 | $12,022.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $478.63 / $1,548.82 / $5,495.41
| Professional | | $478.63 | $1,548.82 | $5,495.41 |