- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $588.84 / $5,370.32 / $8,511.38
| Facility | | $588.84 | $5,370.32 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $281.84 / $426.58 / $741.31
| Professional | | $281.84 | $426.58 | $741.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,801.89 / $4,466.84 / $57,543.99
| Facility | | $3,801.89 | $4,466.84 | $57,543.99 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $426.58 / $457.09 / $457.09
| Professional | | $426.58 | $457.09 | $457.09 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $489.78 / $537.03 / $977.24
| Facility | | $489.78 | $537.03 | $977.24 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $269.15 / $407.38 / $707.95
| Professional | | $269.15 | $407.38 | $707.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $676.08 / $676.08 / $676.08
| Facility | | $676.08 | $676.08 | $676.08 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $549.54 / $741.31 / $1,071.52
| Professional | | $549.54 | $741.31 | $1,071.52 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $436.52 / $575.44 / $691.83
| Facility | | $436.52 | $575.44 | $691.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $380.19 / $575.44 / $912.01
| Professional | | $380.19 | $575.44 | $912.01 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $588.84 / $3,801.89 / $8,317.64
| Facility | | $588.84 | $3,801.89 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $275.42 / $426.58 / $794.33
| Professional | | $275.42 | $426.58 | $794.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $263.03 / $776.25 / $1,071.52
| Professional | | $263.03 | $776.25 | $1,071.52 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $64.57 / $295.12 / $457.09
| Facility | | $64.57 | $295.12 | $457.09 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $64.57 / $302.00 / $489.78
| Professional | | $64.57 | $302.00 | $489.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,659.59 / $4,786.30 / $10,715.19
| Facility | | $1,659.59 | $4,786.30 | $10,715.19 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $245.47 / $398.11 / $707.95
| Professional | | $245.47 | $398.11 | $707.95 |