- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $398.11 / $741.31 / $1,995.26
| Facility | | $398.11 | $741.31 | $1,995.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $338.84 / $512.86 / $933.25
| Professional | | $338.84 | $512.86 | $933.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,630.27 / $4,570.88 / $7,079.46
| Facility | | $2,630.27 | $4,570.88 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $446.68 / $870.96 / $2,290.87
| Professional | | $446.68 | $870.96 | $2,290.87 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,479.11 / $1,698.24 / $2,754.23
| Facility | | $1,479.11 | $1,698.24 | $2,754.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $407.38 / $912.01 / $2,041.74
| Professional | | $407.38 | $912.01 | $2,041.74 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $363.08 / $602.56 / $2,754.23
| Facility | | $363.08 | $602.56 | $2,754.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $660.69 / $977.24 / $1,513.56
| Professional | | $660.69 | $977.24 | $1,513.56 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $371.54 / $616.60 / $4,265.80
| Facility | | $371.54 | $616.60 | $4,265.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $512.86 / $1,122.02 / $4,073.80
| Professional | | $512.86 | $1,122.02 | $4,073.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $512.86
| Professional | | $32.36 | $33.11 | $512.86 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $707.95 / $3,890.45 / $4,570.88
| Facility | | $707.95 | $3,890.45 | $4,570.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $602.56 / $1,047.13 / $1,659.59
| Professional | | $602.56 | $1,047.13 | $1,659.59 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $549.54 / $1,023.29 / $1,778.28
| Professional | | $549.54 | $1,023.29 | $1,778.28 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $602.56 / $7,943.28 / $7,943.28
| Facility | | $602.56 | $7,943.28 | $7,943.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $398.11 / $1,122.02 / $3,890.45
| Professional | | $398.11 | $1,122.02 | $3,890.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,288.25 / $1,288.25 / $2,041.74
| Professional | | $1,288.25 | $1,288.25 | $2,041.74 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,230.27 / $1,819.70 / $2,754.23
| Professional | | $1,230.27 | $1,819.70 | $2,754.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,754.23 / $3,548.13 / $7,244.36
| Facility | | $2,754.23 | $3,548.13 | $7,244.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $380.19 / $645.65 / $1,698.24
| Professional | | $380.19 | $645.65 | $1,698.24 |