- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $691.83 / $7,413.10 / $13,803.84
| Facility | | $691.83 | $7,413.10 | $13,803.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $346.74 / $549.54 / $2,089.30
| Professional | | $346.74 | $549.54 | $2,089.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $562.34 / $676.08 / $1,202.26
| Professional | | $562.34 | $676.08 | $1,202.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,370.32 / $7,413.10 / $15,135.61
| Facility | | $5,370.32 | $7,413.10 | $15,135.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $575.44 / $831.76 / $1,174.90
| Professional | | $575.44 | $831.76 | $1,174.90 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $602.56 / $912.01 / $3,981.07
| Facility | | $602.56 | $912.01 | $3,981.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $380.19 / $660.69 / $1,380.38
| Professional | | $380.19 | $660.69 | $1,380.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $426.58 / $794.33 / $2,511.89
| Facility | | $426.58 | $794.33 | $2,511.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $407.38 / $724.44 / $1,348.96
| Professional | | $407.38 | $724.44 | $1,348.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $229.09
| Professional | | $32.36 | $33.11 | $229.09 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $575.44 / $977.24 / $1,047.13
| Facility | | $575.44 | $977.24 | $1,047.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $707.95 / $707.95 / $1,995.26
| Facility | | $707.95 | $707.95 | $1,995.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $489.78 / $758.58 / $1,318.26
| Professional | | $489.78 | $758.58 | $1,318.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,370.32 / $7,762.47 / $15,135.61
| Facility | | $5,370.32 | $7,762.47 | $15,135.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $575.44 / $851.14 / $1,174.90
| Professional | | $575.44 | $851.14 | $1,174.90 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,318.26 / $7,943.28 / $15,488.17
| Facility | | $1,318.26 | $7,943.28 | $15,488.17 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $416.87 / $616.60 / $1,096.48
| Professional | | $416.87 | $616.60 | $1,096.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $389.05 / $602.56 / $831.76
| Professional | | $389.05 | $602.56 | $831.76 |