- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $407.38 / $758.58 / $14,454.40
| Facility | | $407.38 | $758.58 | $14,454.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $346.74 / $407.38 / $758.58
| Professional | | $346.74 | $407.38 | $758.58 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9,120.11 / $12,302.69 / $20,417.38
| Facility | | $9,120.11 | $12,302.69 | $20,417.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $363.08 / $691.83 / $1,819.70
| Professional | | $363.08 | $691.83 | $1,819.70 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $933.25 / $1,071.52 / $1,737.80
| Facility | | $933.25 | $1,071.52 | $1,737.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $407.38 / $954.99 / $1,513.56
| Professional | | $407.38 | $954.99 | $1,513.56 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $363.08 / $512.86 / $4,897.79
| Facility | | $363.08 | $512.86 | $4,897.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $630.96 / $794.33 / $1,202.26
| Professional | | $630.96 | $794.33 | $1,202.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $371.54 / $562.34 / $15,135.61
| Facility | | $371.54 | $562.34 | $15,135.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $389.05 / $741.31 / $2,754.23
| Professional | | $389.05 | $741.31 | $2,754.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $70.79
| Professional | | $32.36 | $33.11 | $70.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $831.76 / $10,715.19 / $17,378.01
| Facility | | $831.76 | $10,715.19 | $17,378.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $398.11 / $891.25 / $1,445.44
| Professional | | $398.11 | $891.25 | $1,445.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $446.68 / $794.33 / $1,230.27
| Professional | | $446.68 | $794.33 | $1,230.27 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $645.65 / $37,153.52 / $37,153.52
| Facility | | $645.65 | $37,153.52 | $37,153.52 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $398.11 / $1,949.84 / $2,818.38
| Professional | | $398.11 | $1,949.84 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,348.96 / $1,348.96 / $1,348.96
| Professional | | $1,348.96 | $1,348.96 | $1,348.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,000.00 / $1,621.81 / $1,905.46
| Professional | | $1,000.00 | $1,621.81 | $1,905.46 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8,511.38 / $14,125.38 / $18,197.01
| Facility | | $8,511.38 | $14,125.38 | $18,197.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $371.54 / $602.56 / $1,445.44
| Professional | | $371.54 | $602.56 | $1,445.44 |