- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $588.84 / $5,370.32 / $18,620.87
| Facility | | $588.84 | $5,370.32 | $18,620.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $223.87 / $380.19 / $870.96
| Professional | | $223.87 | $380.19 | $870.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $275.42 / $275.42 / $275.42
| Professional | | $275.42 | $275.42 | $275.42 |
- 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
- $416.87 / $645.65 / $912.01
| Professional | | $416.87 | $645.65 | $912.01 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $467.74 / $562.34 / $3,981.07
| Facility | | $467.74 | $562.34 | $3,981.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $269.15 / $467.74 / $1,071.52
| Professional | | $269.15 | $467.74 | $1,071.52 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $269.15 / $549.54 / $2,570.40
| Facility | | $269.15 | $549.54 | $2,570.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $251.19 / $478.63 / $1,071.52
| Professional | | $251.19 | $478.63 | $1,071.52 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $173.78
| Professional | | $32.36 | $33.11 | $173.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $407.38 / $724.44 / $776.25
| Facility | | $407.38 | $724.44 | $776.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $512.86 / $524.81 / $1,995.26
| Facility | | $512.86 | $524.81 | $1,995.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $524.81 / $758.58 / $1,096.48
| Professional | | $524.81 | $758.58 | $1,096.48 |
- 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
- $489.78 / $691.83 / $933.25
| Professional | | $489.78 | $691.83 | $933.25 |
- 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
- $281.84 / $426.58 / $851.14
| Professional | | $281.84 | $426.58 | $851.14 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $389.05 / $446.68 / $831.76
| Professional | | $389.05 | $446.68 | $831.76 |