- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $977.24 / $3,715.35 / $12,882.50
| Facility | | $977.24 | $3,715.35 | $12,882.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $512.86 / $602.56 / $912.01
| Professional | | $512.86 | $602.56 | $912.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $524.81 / $660.69 / $954.99
| Professional | | $524.81 | $660.69 | $954.99 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $537.03 / $537.03 / $588.84
| Facility | | $537.03 | $537.03 | $588.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $354.81 / $891.25 / $1,659.59
| Facility | | $354.81 | $891.25 | $1,659.59 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $501.19 / $707.95 / $1,174.90
| Professional | | $501.19 | $707.95 | $1,174.90 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $54.95 / $56.23 / $3,715.35
| Facility | | $54.95 | $56.23 | $3,715.35 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4,073.80 / $4,897.79 / $4,897.79
| Professional | | $4,073.80 | $4,897.79 | $4,897.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $549.54 / $758.58 / $1,659.59
| Facility | | $549.54 | $758.58 | $1,659.59 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $537.03 / $630.96 / $1,071.52
| Professional | | $537.03 | $630.96 | $1,071.52 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $478.63
| Professional | | $32.36 | $33.11 | $478.63 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $1,047.13 / $1,445.44
| Professional | | $6.03 | $1,047.13 | $1,445.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $549.54 / $724.44 / $1,288.25
| Facility | | $549.54 | $724.44 | $1,288.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $501.19 / $724.44 / $1,318.26
| Professional | | $501.19 | $724.44 | $1,318.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $724.44 / $1,995.26 / $3,981.07
| Facility | | $724.44 | $1,995.26 | $3,981.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $446.68 / $616.60 / $954.99
| Professional | | $446.68 | $616.60 | $954.99 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $426.58 / $575.44 / $660.69
| Professional | | $426.58 | $575.44 | $660.69 |