- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $316.23 / $588.84 / $6,456.54
| Facility | | $316.23 | $588.84 | $6,456.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $275.42 / $389.05 / $724.44
| Professional | | $275.42 | $389.05 | $724.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,311.31 / $4,786.30 / $7,585.78
| Facility | | $3,311.31 | $4,786.30 | $7,585.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $354.81 / $645.65 / $1,778.28
| Professional | | $354.81 | $645.65 | $1,778.28 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,047.13 / $1,230.27 / $1,949.84
| Facility | | $1,047.13 | $1,230.27 | $1,949.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $331.13 / $660.69 / $1,659.59
| Professional | | $331.13 | $660.69 | $1,659.59 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $281.84 / $407.38 / $4,365.16
| Facility | | $281.84 | $407.38 | $4,365.16 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $524.81 / $758.58 / $1,148.15
| Professional | | $524.81 | $758.58 | $1,148.15 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $288.40 / $426.58 / $6,918.31
| Facility | | $288.40 | $426.58 | $6,918.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $398.11 / $851.14 / $2,884.03
| Professional | | $398.11 | $851.14 | $2,884.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $398.11
| Professional | | $32.36 | $33.11 | $398.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $602.56 / $5,754.40 / $7,762.47
| Facility | | $602.56 | $5,754.40 | $7,762.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $426.58 / $812.83 / $1,258.93
| Professional | | $426.58 | $812.83 | $1,258.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $416.87 / $758.58 / $1,318.26
| Professional | | $416.87 | $758.58 | $1,318.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $478.63 / $7,943.28 / $7,943.28
| Facility | | $478.63 | $7,943.28 | $7,943.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $309.03 / $812.83 / $2,818.38
| Professional | | $309.03 | $812.83 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,023.29 / $1,023.29 / $1,445.44
| Professional | | $1,023.29 | $1,023.29 | $1,445.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $870.96 / $1,445.44 / $1,995.26
| Professional | | $870.96 | $1,445.44 | $1,995.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,073.80 / $7,585.78 / $9,120.11
| Facility | | $4,073.80 | $7,585.78 | $9,120.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $302.00 / $512.86 / $1,318.26
| Professional | | $302.00 | $512.86 | $1,318.26 |