- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $398.11 / $758.58 / $14,454.40
| Facility | | $398.11 | $758.58 | $14,454.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $338.84 / $398.11 / $758.58
| Professional | | $338.84 | $398.11 | $758.58 |
- 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
- $346.74 / $691.83 / $1,778.28
| Professional | | $346.74 | $691.83 | $1,778.28 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $954.99 / $1,122.02 / $1,778.28
| Facility | | $954.99 | $1,122.02 | $1,778.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $380.19 / $912.01 / $1,548.82
| Professional | | $380.19 | $912.01 | $1,548.82 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $363.08 / $512.86 / $3,715.35
| Facility | | $363.08 | $512.86 | $3,715.35 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $645.65 / $794.33 / $1,202.26
| Professional | | $645.65 | $794.33 | $1,202.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $371.54 / $602.56 / $7,943.28
| Facility | | $371.54 | $602.56 | $7,943.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $363.08 / $660.69 / $3,981.07
| Professional | | $363.08 | $660.69 | $3,981.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $70.79
| Professional | | $32.36 | $33.11 | $70.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $741.31 / $5,754.40 / $7,762.47
| Facility | | $741.31 | $5,754.40 | $7,762.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $398.11 / $812.83 / $1,412.54
| Professional | | $398.11 | $812.83 | $1,412.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $489.78 / $870.96 / $1,348.96
| Professional | | $489.78 | $870.96 | $1,348.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $630.96 / $7,943.28 / $7,943.28
| Facility | | $630.96 | $7,943.28 | $7,943.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $380.19 / $1,737.80 / $3,981.07
| Professional | | $380.19 | $1,737.80 | $3,981.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,318.26 / $1,318.26 / $1,318.26
| Professional | | $1,318.26 | $1,318.26 | $1,318.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,148.15 / $1,380.38 / $1,819.70
| Professional | | $1,148.15 | $1,380.38 | $1,819.70 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,073.80 / $7,413.10 / $9,120.11
| Facility | | $4,073.80 | $7,413.10 | $9,120.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $346.74 / $524.81 / $1,380.38
| Professional | | $346.74 | $524.81 | $1,380.38 |