- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $616.60 / $5,128.61 / $9,549.93
| Facility | | $616.60 | $5,128.61 | $9,549.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $371.54 / $575.44 / $1,148.15
| Professional | | $371.54 | $575.44 | $1,148.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $616.60 / $616.60 / $616.60
| Professional | | $616.60 | $616.60 | $616.60 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,019.95 / $4,073.80 / $30,199.52
| Facility | | $3,019.95 | $4,073.80 | $30,199.52 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $588.84 / $851.14 / $912.01
| Professional | | $588.84 | $851.14 | $912.01 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,456.54 / $7,585.78 / $57,543.99
| Facility | | $6,456.54 | $7,585.78 | $57,543.99 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $478.63 / $954.99 / $1,412.54
| Professional | | $478.63 | $954.99 | $1,412.54 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $724.44 / $1,445.44 / $2,089.30
| Professional | 50 | $724.44 | $1,445.44 | $2,089.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $316.23 / $660.69 / $1,071.52
| Professional | | $316.23 | $660.69 | $1,071.52 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $794.33 / $794.33 / $851.14
| Professional | | $794.33 | $794.33 | $851.14 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $549.54 / $707.95 / $1,174.90
| Professional | | $549.54 | $707.95 | $1,174.90 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,677.35 / $7,413.10 / $11,748.98
| Facility | | $4,677.35 | $7,413.10 | $11,748.98 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $6,606.93 / $7,943.28 / $14,125.38
| Facility | 50 | $6,606.93 | $7,943.28 | $14,125.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $354.81 / $407.38 / $588.84
| Professional | | $354.81 | $407.38 | $588.84 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $630.96 / $630.96 / $891.25
| Professional | 50 | $630.96 | $630.96 | $891.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,691.53 / $3,630.78 / $8,912.51
| Facility | | $2,691.53 | $3,630.78 | $8,912.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $426.58 / $851.14 / $912.01
| Professional | | $426.58 | $851.14 | $912.01 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $537.03 / $3,235.94 / $8,317.64
| Facility | | $537.03 | $3,235.94 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $389.05 / $630.96 / $1,230.27
| Professional | | $389.05 | $630.96 | $1,230.27 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $676.08 / $676.08 / $1,584.89
| Professional | | $676.08 | $676.08 | $1,584.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $323.59 / $588.84 / $794.33
| Facility | | $323.59 | $588.84 | $794.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $309.03 / $478.63 / $794.33
| Professional | | $309.03 | $478.63 | $794.33 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,137.96 / $4,570.88 / $10,232.93
| Facility | | $2,137.96 | $4,570.88 | $10,232.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $338.84 / $575.44 / $1,023.29
| Professional | | $338.84 | $575.44 | $1,023.29 |