- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,000.00 / $3,715.35 / $12,882.50
| Facility | | $1,000.00 | $3,715.35 | $12,882.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $660.69 / $794.33 / $1,202.26
| Professional | | $660.69 | $794.33 | $1,202.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,884.03 / $5,128.61 / $9,332.54
| Facility | | $2,884.03 | $5,128.61 | $9,332.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $660.69 / $794.33 / $1,148.15
| Professional | | $660.69 | $794.33 | $1,148.15 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $691.83 / $691.83 / $741.31
| Facility | | $691.83 | $691.83 | $741.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,258.93 / $2,041.74 / $2,818.38
| Facility | | $1,258.93 | $2,041.74 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $630.96 / $912.01 / $1,513.56
| Professional | | $630.96 | $912.01 | $1,513.56 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9,772.37 / $33,884.42 / $33,884.42
| Facility | | $9,772.37 | $33,884.42 | $33,884.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5,248.07 / $6,456.54 / $6,456.54
| Professional | | $5,248.07 | $6,456.54 | $6,456.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $707.95 / $977.24 / $2,511.89
| Facility | | $707.95 | $977.24 | $2,511.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $691.83 / $831.76 / $1,412.54
| Professional | | $691.83 | $831.76 | $1,412.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $616.60
| Professional | | $32.36 | $33.11 | $616.60 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $741.31 / $1,318.26 / $1,778.28
| Professional | | $741.31 | $1,318.26 | $1,778.28 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $707.95 / $933.25 / $1,621.81
| Facility | | $707.95 | $933.25 | $1,621.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $616.60 / $933.25 / $1,659.59
| Professional | | $616.60 | $933.25 | $1,659.59 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,698.24 / $4,365.16 / $9,120.11
| Facility | | $1,698.24 | $4,365.16 | $9,120.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $588.84 / $812.83 / $1,230.27
| Professional | | $588.84 | $812.83 | $1,230.27 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $524.81 / $741.31 / $851.14
| Professional | | $524.81 | $741.31 | $851.14 |