- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,659.59 / $5,888.44 / $16,595.87
| Facility | | $1,659.59 | $5,888.44 | $16,595.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $141.25 / $478.63 / $1,412.54
| Professional | | $141.25 | $478.63 | $1,412.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,570.40 / $4,466.84 / $12,882.50
| Facility | | $2,570.40 | $4,466.84 | $12,882.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $275.42 / $1,000.00 / $1,995.26
| Professional | | $275.42 | $1,000.00 | $1,995.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $77.62 / $100.00 / $100.00
| Facility | | $77.62 | $100.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $165.96 / $537.03 / $1,318.26
| Professional | | $165.96 | $537.03 | $1,318.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $165.96 / $501.19 / $1,230.27
| Professional | | $165.96 | $501.19 | $1,230.27 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $131.83 / $478.63 / $758.58
| Professional | | $131.83 | $478.63 | $758.58 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $125.89 / $407.38 / $933.25
| Professional | | $125.89 | $407.38 | $933.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $54.95 / $56.23 / $1,479.11
| Facility | | $54.95 | $56.23 | $1,479.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,388.44 / $3,981.07 / $3,981.07
| Professional | | $3,388.44 | $3,981.07 | $3,981.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $389.05 / $389.05 / $660.69
| Professional | | $389.05 | $389.05 | $660.69 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $147.91 / $478.63 / $912.01
| Facility | | $147.91 | $478.63 | $912.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $165.96 / $446.68 / $1,202.26
| Professional | | $165.96 | $446.68 | $1,202.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $501.19 / $501.19 / $2,089.30
| Professional | | $501.19 | $501.19 | $2,089.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $120.23 / $524.81 / $812.83
| Professional | | $120.23 | $524.81 | $812.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $575.44 / $1,584.89 / $6,760.83
| Facility | | $575.44 | $1,584.89 | $6,760.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $144.54 / $489.78 / $1,174.90
| Professional | | $144.54 | $489.78 | $1,174.90 |