- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $346.74 / $691.83 / $1,905.46
| Facility | | $346.74 | $691.83 | $1,905.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $338.84 / $426.58 / $870.96
| Professional | | $338.84 | $426.58 | $870.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7,585.78 / $16,982.44 / $29,512.09
| Facility | | $7,585.78 | $16,982.44 | $29,512.09 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $416.87 / $794.33 / $1,949.84
| Professional | | $416.87 | $794.33 | $1,949.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,096.48 / $1,288.25 / $2,041.74
| Facility | | $1,096.48 | $1,288.25 | $2,041.74 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $446.68 / $933.25 / $1,513.56
| Professional | | $446.68 | $933.25 | $1,513.56 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $380.19 / $851.14 / $3,801.89
| Facility | | $380.19 | $851.14 | $3,801.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $724.44 / $933.25 / $1,230.27
| Professional | | $724.44 | $933.25 | $1,230.27 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $389.05 / $3,162.28 / $8,709.64
| Facility | | $389.05 | $3,162.28 | $8,709.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $436.52 / $831.76 / $2,570.40
| Professional | | $436.52 | $831.76 | $2,570.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $562.34
| Professional | | $32.36 | $33.11 | $562.34 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $676.08 / $5,754.40 / $7,762.47
| Facility | | $676.08 | $5,754.40 | $7,762.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $575.44 / $1,096.48 / $1,548.82
| Professional | | $575.44 | $1,096.48 | $1,548.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $489.78 / $1,000.00 / $1,513.56
| Professional | | $489.78 | $1,000.00 | $1,513.56 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $18,197.01 / $26,915.35 / $26,915.35
| Facility | | $18,197.01 | $26,915.35 | $26,915.35 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $457.09 / $1,258.93 / $6,165.95
| Professional | | $457.09 | $1,258.93 | $6,165.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,737.80 / $1,737.80 / $2,137.96
| Professional | | $1,737.80 | $1,737.80 | $2,137.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,905.46 / $2,238.72 / $2,884.03
| Professional | | $1,905.46 | $2,238.72 | $2,884.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,370.32 / $7,585.78 / $9,772.37
| Facility | | $5,370.32 | $7,585.78 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $407.38 / $660.69 / $1,698.24
| Professional | | $407.38 | $660.69 | $1,698.24 |