- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $954.99 / $3,311.31 / $11,481.54
| Facility | | $954.99 | $3,311.31 | $11,481.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $891.25 / $1,071.52 / $2,570.40
| Professional | | $891.25 | $1,071.52 | $2,570.40 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,691.53 / $3,162.28 / $3,467.37
| Facility | | $2,691.53 | $3,162.28 | $3,467.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $977.24 / $1,380.38 / $2,691.53
| Professional | | $977.24 | $1,380.38 | $2,691.53 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $323.59 / $512.86 / $35,481.34
| Facility | | $323.59 | $512.86 | $35,481.34 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $933.25 / $1,288.25 / $2,290.87
| Professional | | $933.25 | $1,288.25 | $2,290.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,445.44 / $1,445.44 / $1,445.44
| Professional | | $1,445.44 | $1,445.44 | $1,445.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $912.01 / $1,148.15 / $1,819.70
| Facility | | $912.01 | $1,148.15 | $1,819.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $912.01 / $912.01 / $2,570.40
| Professional | | $912.01 | $912.01 | $2,570.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $933.25 / $1,348.96 / $1,479.11
| Professional | | $933.25 | $1,348.96 | $1,479.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,202.26 / $6,456.54 / $14,454.40
| Facility | | $1,202.26 | $6,456.54 | $14,454.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $776.25 / $1,023.29 / $1,862.09
| Professional | | $776.25 | $1,023.29 | $1,862.09 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $56.23 / $9,772.37 / $9,772.37
| Facility | | $56.23 | $9,772.37 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7,244.36 / $7,244.36 / $8,317.64
| Professional | | $7,244.36 | $7,244.36 | $8,317.64 |