- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,047.13 / $3,981.07 / $8,317.64
| Facility | | $1,047.13 | $3,981.07 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $616.60 / $707.95 / $1,202.26
| Professional | | $616.60 | $707.95 | $1,202.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,630.27 / $2,691.53 / $57,543.99
| Facility | | $2,630.27 | $2,691.53 | $57,543.99 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $575.44 / $676.08 / $1,148.15
| Professional | | $575.44 | $676.08 | $1,148.15 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $489.78 / $5,248.07 / $10,471.29
| Facility | | $489.78 | $5,248.07 | $10,471.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $467.74 / $741.31 / $1,288.25
| Professional | | $467.74 | $741.31 | $1,288.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,412.54 / $1,412.54 / $1,412.54
| Facility | | $1,412.54 | $1,412.54 | $1,412.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $660.69 / $891.25 / $1,288.25
| Professional | | $660.69 | $891.25 | $1,288.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,265.80 / $4,570.88 / $6,606.93
| Facility | | $4,265.80 | $4,570.88 | $6,606.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $602.56 / $724.44 / $1,122.02
| Professional | | $602.56 | $724.44 | $1,122.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $831.76 / $2,570.40 / $8,317.64
| Facility | | $831.76 | $2,570.40 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $575.44 / $707.95 / $1,412.54
| Professional | | $575.44 | $707.95 | $1,412.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $933.25 / $1,258.93 / $1,479.11
| Professional | | $933.25 | $1,258.93 | $1,479.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $501.19 / $645.65 / $645.65
| Facility | | $501.19 | $645.65 | $645.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $630.96 / $645.65 / $691.83
| Professional | | $630.96 | $645.65 | $691.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,737.80 / $4,897.79 / $19,054.61
| Facility | | $1,737.80 | $4,897.79 | $19,054.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $537.03 / $707.95 / $1,230.27
| Professional | | $537.03 | $707.95 | $1,230.27 |