- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $831.76 / $2,691.53 / $8,317.64
| Facility | | $831.76 | $2,691.53 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $208.93 / $269.15 / $467.74
| Professional | | $208.93 | $269.15 | $467.74 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,801.89 / $4,466.84 / $57,543.99
| Facility | | $3,801.89 | $4,466.84 | $57,543.99 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $199.53 / $234.42 / $389.05
| Professional | | $199.53 | $234.42 | $389.05 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $389.05 / $933.25 / $1,819.70
| Facility | | $389.05 | $933.25 | $1,819.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $181.97 / $275.42 / $489.78
| Professional | | $181.97 | $275.42 | $489.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $457.09 / $457.09 / $457.09
| Facility | | $457.09 | $457.09 | $457.09 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $208.93 / $281.84 / $426.58
| Professional | | $208.93 | $281.84 | $426.58 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $741.31 / $954.99 / $1,122.02
| Facility | | $741.31 | $954.99 | $1,122.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $204.17 / $263.03 / $346.74
| Professional | | $204.17 | $263.03 | $346.74 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $588.84 / $1,995.26 / $7,244.36
| Facility | | $588.84 | $1,995.26 | $7,244.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $213.80 / $269.15 / $812.83
| Professional | | $213.80 | $269.15 | $812.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $380.19 / $562.34
| Professional | | $3.98 | $380.19 | $562.34 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $223.87 / $269.15 / $269.15
| Facility | | $223.87 | $269.15 | $269.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $223.87 / $229.09 / $416.87
| Professional | | $223.87 | $229.09 | $416.87 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $602.56 / $2,398.83 / $4,265.80
| Facility | | $602.56 | $2,398.83 | $4,265.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $190.55 / $263.03 / $446.68
| Professional | | $190.55 | $263.03 | $446.68 |