- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $562.34 / $1,148.15 / $14,454.40
| Facility | | $562.34 | $1,148.15 | $14,454.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $524.81 / $575.44 / $1,380.38
| Professional | | $524.81 | $575.44 | $1,380.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,165.95 / $10,232.93 / $18,197.01
| Facility | | $6,165.95 | $10,232.93 | $18,197.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $549.54 / $1,047.13 / $2,570.40
| Professional | | $549.54 | $1,047.13 | $2,570.40 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,412.54 / $1,659.59 / $2,630.27
| Facility | | $1,412.54 | $1,659.59 | $2,630.27 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $616.60 / $1,778.28 / $1,995.26
| Professional | | $616.60 | $1,778.28 | $1,995.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $562.34 / $2,570.40 / $4,786.30
| Facility | | $562.34 | $2,570.40 | $4,786.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $977.24 / $1,380.38 / $1,698.24
| Professional | | $977.24 | $1,380.38 | $1,698.24 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $602.56 / $3,548.13 / $6,309.57
| Facility | | $602.56 | $3,548.13 | $6,309.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $562.34 / $1,023.29 / $3,801.89
| Professional | | $562.34 | $1,023.29 | $3,801.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $758.58
| Professional | | $32.36 | $33.11 | $758.58 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,096.48 / $3,890.45 / $4,570.88
| Facility | | $1,096.48 | $3,890.45 | $4,570.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $758.58 / $1,380.38 / $1,819.70
| Professional | | $758.58 | $1,380.38 | $1,819.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $645.65 / $1,230.27 / $2,344.23
| Professional | | $645.65 | $1,230.27 | $2,344.23 |
- 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
- $758.58 / $2,754.23 / $4,073.80
| Professional | | $758.58 | $2,754.23 | $4,073.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,818.38 / $2,818.38 / $2,818.38
| Professional | | $2,818.38 | $2,818.38 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,570.40 / $3,235.94 / $4,073.80
| Professional | | $2,570.40 | $3,235.94 | $4,073.80 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,884.03 / $3,630.78 / $7,413.10
| Facility | | $2,884.03 | $3,630.78 | $7,413.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $549.54 / $954.99 / $2,454.71
| Professional | | $549.54 | $954.99 | $2,454.71 |