- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,122.02 / $6,456.54 / $10,964.78
| Facility | | $1,122.02 | $6,456.54 | $10,964.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $457.09 / $645.65 / $1,778.28
| Professional | | $457.09 | $645.65 | $1,778.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $398.11 / $398.11 / $398.11
| Professional | | $398.11 | $398.11 | $398.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,071.52 / $7,244.36 / $30,199.52
| Facility | | $1,071.52 | $7,244.36 | $30,199.52 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $169.82 / $331.13 / $537.03
| Professional | | $169.82 | $331.13 | $537.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $489.78 / $512.86 / $630.96
| Facility | | $489.78 | $512.86 | $630.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $537.03 / $537.03 / $602.56
| Professional | | $537.03 | $537.03 | $602.56 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $512.86 / $891.25 / $1,202.26
| Facility | | $512.86 | $891.25 | $1,202.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $489.78 / $812.83 / $1,548.82
| Professional | | $489.78 | $812.83 | $1,548.82 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $34.67 / $602.56 / $21,379.62
| Facility | | $34.67 | $602.56 | $21,379.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $457.09 / $794.33 / $1,380.38
| Professional | | $457.09 | $794.33 | $1,380.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $33.11 / $173.78 / $251.19
| Professional | | $33.11 | $173.78 | $251.19 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13,803.84 / $13,803.84 / $13,803.84
| Facility | | $13,803.84 | $13,803.84 | $13,803.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $323.59 / $380.19 / $724.44
| Professional | | $323.59 | $380.19 | $724.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,380.38 / $9,549.93 / $21,379.62
| Facility | | $1,380.38 | $9,549.93 | $21,379.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $288.40 / $446.68 / $1,258.93
| Professional | | $288.40 | $446.68 | $1,258.93 |