- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $812.83 / $3,630.78 / $9,549.93
| Facility | | $812.83 | $3,630.78 | $9,549.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $616.60 / $741.31 / $1,202.26
| Professional | | $616.60 | $741.31 | $1,202.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,760.83 / $11,220.18 / $15,135.61
| Facility | | $6,760.83 | $11,220.18 | $15,135.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $660.69 / $891.25 / $1,380.38
| Professional | | $660.69 | $891.25 | $1,380.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $691.83 / $812.83 / $5,128.61
| Professional | | $691.83 | $812.83 | $5,128.61 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $489.78 / $524.81 / $1,174.90
| Facility | | $489.78 | $524.81 | $1,174.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $602.56 / $812.83 / $1,318.26
| Professional | | $602.56 | $812.83 | $1,318.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $630.96 / $758.58 / $1,258.93
| Professional | | $630.96 | $758.58 | $1,258.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $870.96 / $933.25 / $1,621.81
| Professional | | $870.96 | $933.25 | $1,621.81 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $660.69 / $912.01 / $1,380.38
| Facility | | $660.69 | $912.01 | $1,380.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $891.25 / $891.25 / $1,380.38
| Professional | | $891.25 | $891.25 | $1,380.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $676.08 / $831.76 / $2,137.96
| Facility | | $676.08 | $831.76 | $2,137.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $676.08 / $831.76 / $2,137.96
| Professional | | $676.08 | $831.76 | $2,137.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $512.86 / $3,162.28 / $5,754.40
| Facility | | $512.86 | $3,162.28 | $5,754.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $549.54 / $794.33 / $1,318.26
| Professional | | $549.54 | $794.33 | $1,318.26 |