- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $363.08 / $3,467.37 / $7,244.36
| Facility | | $363.08 | $3,467.37 | $7,244.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $251.19 / $323.59 / $512.86
| Professional | | $251.19 | $323.59 | $512.86 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,606.93 / $7,413.10 / $9,332.54
| Facility | | $6,606.93 | $7,413.10 | $9,332.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $269.15 / $380.19 / $602.56
| Professional | | $269.15 | $380.19 | $602.56 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $245.47 / $288.40 / $5,011.87
| Professional | | $245.47 | $288.40 | $5,011.87 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $436.52 / $2,951.21 / $3,311.31
| Facility | | $436.52 | $2,951.21 | $3,311.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $263.03 / $363.08 / $562.34
| Professional | | $263.03 | $363.08 | $562.34 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $316.23 / $389.05 / $645.65
| Professional | | $316.23 | $389.05 | $645.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $398.11 / $467.74 / $616.60
| Professional | | $398.11 | $467.74 | $616.60 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $269.15 / $398.11 / $616.60
| Facility | | $269.15 | $398.11 | $616.60 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $371.54 / $371.54 / $724.44
| Professional | | $371.54 | $371.54 | $724.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $257.04 / $331.13 / $1,445.44
| Facility | | $257.04 | $331.13 | $1,445.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $323.59 / $398.11 / $1,548.82
| Professional | | $323.59 | $398.11 | $1,548.82 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,348.96 / $5,495.41 / $12,882.50
| Facility | | $1,348.96 | $5,495.41 | $12,882.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $229.09 / $346.74 / $562.34
| Professional | | $229.09 | $346.74 | $562.34 |