- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $323.59 / $2,818.38 / $3,981.07
| Facility | | $323.59 | $2,818.38 | $3,981.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $229.09 / $380.19 / $831.76
| Professional | | $229.09 | $380.19 | $831.76 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $912.01 / $3,981.07 / $19,498.45
| Facility | | $912.01 | $3,981.07 | $19,498.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $281.84 / $501.19 / $2,754.23
| Professional | | $281.84 | $501.19 | $2,754.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $457.09 / $794.33 / $1,479.11
| Professional | | $457.09 | $794.33 | $1,479.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $199.53 / $676.08 / $3,090.30
| Facility | | $199.53 | $676.08 | $3,090.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $245.47 / $467.74 / $954.99
| Professional | | $245.47 | $467.74 | $954.99 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $316.23 / $512.86 / $3,311.31
| Facility | | $316.23 | $512.86 | $3,311.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $363.08 / $512.86 / $741.31
| Professional | | $363.08 | $512.86 | $741.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $524.81 / $3,801.89 / $9,772.37
| Facility | | $524.81 | $3,801.89 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $398.11 / $676.08 / $1,071.52
| Professional | | $398.11 | $676.08 | $1,071.52 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $158.49 / $3,890.45 / $5,011.87
| Facility | | $158.49 | $3,890.45 | $5,011.87 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $912.01 / $3,981.07 / $19,498.45
| Facility | | $912.01 | $3,981.07 | $19,498.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $281.84 / $501.19 / $2,754.23
| Professional | | $281.84 | $501.19 | $2,754.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $524.81 / $3,548.13 / $9,120.11
| Facility | | $524.81 | $3,548.13 | $9,120.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $269.15 / $512.86 / $1,071.52
| Professional | | $269.15 | $512.86 | $1,071.52 |