- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $676.08 / $3,630.78 / $8,317.64
| Facility | | $676.08 | $3,630.78 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $489.78 / $616.60 / $1,096.48
| Professional | | $489.78 | $616.60 | $1,096.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,090.30 / $3,981.07 / $4,466.84
| Facility | | $3,090.30 | $3,981.07 | $4,466.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $537.03 / $741.31 / $1,122.02
| Professional | | $537.03 | $741.31 | $1,122.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $575.44 / $660.69 / $3,311.31
| Professional | | $575.44 | $660.69 | $3,311.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $457.09 / $1,288.25 / $1,584.89
| Facility | | $457.09 | $1,288.25 | $1,584.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $446.68 / $630.96 / $1,071.52
| Professional | | $446.68 | $630.96 | $1,071.52 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $537.03 / $660.69 / $1,096.48
| Professional | | $537.03 | $660.69 | $1,096.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $588.84 / $645.65 / $954.99
| Professional | | $588.84 | $645.65 | $954.99 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $524.81 / $724.44 / $1,122.02
| Facility | | $524.81 | $724.44 | $1,122.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $588.84 / $588.84 / $954.99
| Professional | | $588.84 | $588.84 | $954.99 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $501.19 / $645.65 / $2,454.71
| Facility | | $501.19 | $645.65 | $2,454.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $501.19 / $645.65 / $2,454.71
| Professional | | $501.19 | $645.65 | $2,454.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,348.96 / $5,495.41 / $12,882.50
| Facility | | $1,348.96 | $5,495.41 | $12,882.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $426.58 / $602.56 / $1,071.52
| Professional | | $426.58 | $602.56 | $1,071.52 |