- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $478.63 / $2,754.23 / $5,128.61
| Facility | | $478.63 | $2,754.23 | $5,128.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $338.84 / $489.78 / $977.24
| Professional | | $338.84 | $489.78 | $977.24 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $776.25 / $3,630.78 / $28,840.32
| Facility | | $776.25 | $3,630.78 | $28,840.32 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $363.08 / $630.96 / $3,801.89
| Professional | | $363.08 | $630.96 | $3,801.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $416.87 / $416.87 / $933.25
| Facility | | $416.87 | $416.87 | $933.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $602.56 / $1,659.59 / $1,659.59
| Professional | | $602.56 | $1,659.59 | $1,659.59 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $588.84 / $645.65 / $3,090.30
| Facility | | $588.84 | $645.65 | $3,090.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $346.74 / $616.60 / $1,318.26
| Professional | | $346.74 | $616.60 | $1,318.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $295.12 / $457.09 / $3,311.31
| Facility | | $295.12 | $457.09 | $3,311.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $512.86 / $724.44 / $1,047.13
| Professional | | $512.86 | $724.44 | $1,047.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $616.60 / $3,162.28 / $8,511.38
| Facility | | $616.60 | $3,162.28 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $371.54 / $660.69 / $1,318.26
| Professional | | $371.54 | $660.69 | $1,318.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $776.25 / $3,630.78 / $28,840.32
| Facility | | $776.25 | $3,630.78 | $28,840.32 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $363.08 / $630.96 / $3,801.89
| Professional | | $363.08 | $630.96 | $3,801.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $616.60 / $2,951.21 / $8,511.38
| Facility | | $616.60 | $2,951.21 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $371.54 / $660.69 / $1,380.38
| Professional | | $371.54 | $660.69 | $1,380.38 |