- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $467.74 / $954.99 / $14,454.40
| Facility | | $467.74 | $954.99 | $14,454.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $436.52 / $478.63 / $1,148.15
| Professional | | $436.52 | $478.63 | $1,148.15 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,165.95 / $10,232.93 / $17,378.01
| Facility | | $6,165.95 | $10,232.93 | $17,378.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $467.74 / $891.25 / $2,238.72
| Professional | | $467.74 | $891.25 | $2,238.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,202.26 / $1,380.38 / $2,238.72
| Facility | | $1,202.26 | $1,380.38 | $2,238.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $524.81 / $1,479.11 / $1,659.59
| Professional | | $524.81 | $1,479.11 | $1,659.59 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $467.74 / $2,570.40 / $4,786.30
| Facility | | $467.74 | $2,570.40 | $4,786.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $831.76 / $1,148.15 / $1,412.54
| Professional | | $831.76 | $1,148.15 | $1,412.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $467.74 / $3,548.13 / $6,309.57
| Facility | | $467.74 | $3,548.13 | $6,309.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $478.63 / $851.14 / $3,162.28
| Professional | | $478.63 | $851.14 | $3,162.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $630.96
| Professional | | $32.36 | $33.11 | $630.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $933.25 / $3,890.45 / $4,570.88
| Facility | | $933.25 | $3,890.45 | $4,570.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $645.65 / $1,174.90 / $1,513.56
| Professional | | $645.65 | $1,174.90 | $1,513.56 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $537.03 / $1,047.13 / $1,995.26
| Professional | | $537.03 | $1,047.13 | $1,995.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9,772.37 / $14,454.40 / $14,454.40
| Facility | | $9,772.37 | $14,454.40 | $14,454.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $630.96 / $2,290.87 / $3,388.44
| Professional | | $630.96 | $2,290.87 | $3,388.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,398.83 / $2,398.83 / $2,398.83
| Professional | | $2,398.83 | $2,398.83 | $2,398.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,187.76 / $2,754.23 / $3,467.37
| Professional | | $2,187.76 | $2,754.23 | $3,467.37 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,884.03 / $3,630.78 / $7,244.36
| Facility | | $2,884.03 | $3,630.78 | $7,244.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $446.68 / $812.83 / $2,041.74
| Professional | | $446.68 | $812.83 | $2,041.74 |