- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $281.84 / $537.03 / $3,090.30
| Facility | | $281.84 | $537.03 | $3,090.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $251.19 / $323.59 / $562.34
| Professional | | $251.19 | $323.59 | $562.34 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,606.93 / $10,964.78 / $18,197.01
| Facility | | $6,606.93 | $10,964.78 | $18,197.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $316.23 / $588.84 / $1,513.56
| Professional | | $316.23 | $588.84 | $1,513.56 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $870.96 / $1,023.29 / $1,621.81
| Facility | | $870.96 | $1,023.29 | $1,621.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $295.12 / $575.44 / $1,230.27
| Professional | | $295.12 | $575.44 | $1,230.27 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $257.04 / $398.11 / $3,311.31
| Facility | | $257.04 | $398.11 | $3,311.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $457.09 / $645.65 / $977.24
| Professional | | $457.09 | $645.65 | $977.24 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $263.03 / $407.38 / $6,918.31
| Facility | | $263.03 | $407.38 | $6,918.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $338.84 / $724.44 / $2,454.71
| Professional | | $338.84 | $724.44 | $2,454.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $346.74
| Professional | | $32.36 | $33.11 | $346.74 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $524.81 / $5,754.40 / $7,762.47
| Facility | | $524.81 | $5,754.40 | $7,762.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $363.08 / $724.44 / $1,122.02
| Professional | | $363.08 | $724.44 | $1,122.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $363.08 / $645.65 / $1,148.15
| Professional | | $363.08 | $645.65 | $1,148.15 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $436.52 / $16,595.87 / $16,595.87
| Facility | | $436.52 | $16,595.87 | $16,595.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $275.42 / $691.83 / $2,398.83
| Professional | | $275.42 | $691.83 | $2,398.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $933.25 / $933.25 / $1,230.27
| Professional | | $933.25 | $933.25 | $1,230.27 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $776.25 / $1,230.27 / $1,659.59
| Professional | | $776.25 | $1,230.27 | $1,659.59 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,897.79 / $7,585.78 / $9,772.37
| Facility | | $4,897.79 | $7,585.78 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $275.42 / $426.58 / $1,122.02
| Professional | | $275.42 | $426.58 | $1,122.02 |