- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $426.58 / $4,365.16 / $14,791.08
| Facility | | $426.58 | $4,365.16 | $14,791.08 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $288.40 / $407.38 / $1,258.93
| Professional | | $288.40 | $407.38 | $1,258.93 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,888.44 / $6,760.83 / $7,413.10
| Facility | | $5,888.44 | $6,760.83 | $7,413.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $346.74 / $446.68 / $724.44
| Professional | | $346.74 | $446.68 | $724.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $426.58 / $467.74 / $851.14
| Professional | | $426.58 | $467.74 | $851.14 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $489.78 / $524.81 / $616.60
| Facility | | $489.78 | $524.81 | $616.60 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $354.81 / $478.63 / $851.14
| Professional | | $354.81 | $478.63 | $851.14 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $309.03 / $371.54 / $537.03
| Professional | | $309.03 | $371.54 | $537.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $346.74 / $467.74 / $870.96
| Facility | | $346.74 | $467.74 | $870.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $229.09 / $416.87 / $2,187.76
| Facility | | $229.09 | $416.87 | $2,187.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $229.09 / $416.87 / $2,187.76
| Professional | | $229.09 | $416.87 | $2,187.76 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $478.63 / $3,162.28 / $5,754.40
| Facility | | $478.63 | $3,162.28 | $5,754.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $204.17 / $363.08 / $588.84
| Professional | | $204.17 | $363.08 | $588.84 |