- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $501.19 / $4,570.88 / $10,715.19
| Facility | | $501.19 | $4,570.88 | $10,715.19 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $269.15 / $602.56 / $4,677.35
| Professional | | $269.15 | $602.56 | $4,677.35 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $446.68 / $446.68 / $446.68
| Professional | | $446.68 | $446.68 | $446.68 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,290.87 / $3,162.28 / $6,456.54
| Facility | | $2,290.87 | $3,162.28 | $6,456.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $426.58 / $870.96 / $5,754.40
| Professional | | $426.58 | $870.96 | $5,754.40 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $457.09 / $870.96 / $1,819.70
| Facility | | $457.09 | $870.96 | $1,819.70 |
- Facility/Professional
- Facility
- Modifier
- 22
- Typical Low / Median / Typical High
- $549.54 / $549.54 / $549.54
| Facility | 22 | $549.54 | $549.54 | $549.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $309.03 / $741.31 / $6,918.31
| Professional | | $309.03 | $741.31 | $6,918.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $380.19 / $1,230.27 / $6,309.57
| Facility | | $380.19 | $1,230.27 | $6,309.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $323.59 / $1,174.90 / $6,456.54
| Professional | | $323.59 | $1,174.90 | $6,456.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $117.49
| Professional | | $32.36 | $33.11 | $117.49 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,311.31 / $4,570.88 / $6,025.60
| Facility | | $3,311.31 | $4,570.88 | $6,025.60 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $741.31 / $3,311.31 / $3,548.13
| Facility | | $741.31 | $3,311.31 | $3,548.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $363.08 / $3,311.31 / $6,165.95
| Professional | | $363.08 | $3,311.31 | $6,165.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,238.72 / $3,235.94 / $6,456.54
| Facility | | $2,238.72 | $3,235.94 | $6,456.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $426.58 / $870.96 / $5,888.44
| Professional | | $426.58 | $870.96 | $5,888.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $870.96 / $3,715.35 / $6,918.31
| Facility | | $870.96 | $3,715.35 | $6,918.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $338.84 / $741.31 / $5,495.41
| Professional | | $338.84 | $741.31 | $5,495.41 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $257.04 / $489.78 / $3,890.45
| Professional | | $257.04 | $489.78 | $3,890.45 |