- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $407.38 / $2,630.27 / $8,317.64
| Facility | | $407.38 | $2,630.27 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $331.13 / $407.38 / $933.25
| Professional | | $331.13 | $407.38 | $933.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,606.93 / $7,413.10 / $9,332.54
| Facility | | $6,606.93 | $7,413.10 | $9,332.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $331.13 / $436.52 / $630.96
| Professional | | $331.13 | $436.52 | $630.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $371.54 / $2,454.71 / $8,317.64
| Professional | | $371.54 | $2,454.71 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $338.84 / $467.74 / $707.95
| Professional | | $338.84 | $467.74 | $707.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $302.00 / $363.08 / $933.25
| Professional | | $302.00 | $363.08 | $933.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $501.19 / $630.96 / $812.83
| Professional | | $501.19 | $630.96 | $812.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $346.74 / $512.86 / $741.31
| Facility | | $346.74 | $512.86 | $741.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $338.84 / $478.63 / $8,709.64
| Facility | | $338.84 | $478.63 | $8,709.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $338.84 / $478.63 / $8,709.64
| Professional | | $338.84 | $478.63 | $8,709.64 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,715.35 / $6,165.95 / $12,882.50
| Facility | | $3,715.35 | $6,165.95 | $12,882.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $309.03 / $457.09 / $724.44
| Professional | | $309.03 | $457.09 | $724.44 |