- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,174.90 / $5,495.41 / $15,848.93
| Facility | | $1,174.90 | $5,495.41 | $15,848.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $141.25 / $245.47 / $812.83
| Professional | | $141.25 | $245.47 | $812.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,511.89 / $4,570.88 / $12,882.50
| Facility | | $2,511.89 | $4,570.88 | $12,882.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $194.98 / $323.59 / $676.08
| Professional | | $194.98 | $323.59 | $676.08 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $85.11 / $3,890.45 / $7,079.46
| Facility | | $85.11 | $3,890.45 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $190.55 / $331.13 / $707.95
| Professional | | $190.55 | $331.13 | $707.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,202.26 / $1,202.26 / $1,445.44
| Facility | | $1,202.26 | $1,202.26 | $1,445.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $165.96 / $288.40 / $616.60
| Professional | | $165.96 | $288.40 | $616.60 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $138.04 / $302.00 / $416.87
| Professional | | $138.04 | $302.00 | $416.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $128.82 / $251.19 / $457.09
| Professional | | $128.82 | $251.19 | $457.09 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $54.95 / $56.23 / $5,623.41
| Facility | | $54.95 | $56.23 | $5,623.41 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,187.76 / $2,187.76 / $2,187.76
| Professional | | $2,187.76 | $2,187.76 | $2,187.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $199.53 / $199.53 / $338.84
| Professional | | $199.53 | $199.53 | $338.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $154.88 / $269.15 / $478.63
| Facility | | $154.88 | $269.15 | $478.63 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $162.18 / $288.40 / $562.34
| Professional | | $162.18 | $288.40 | $562.34 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $478.63 / $478.63 / $776.25
| Professional | | $478.63 | $478.63 | $776.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $125.89 / $346.74 / $524.81
| Professional | | $125.89 | $346.74 | $524.81 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,801.89 / $7,244.36 / $15,135.61
| Facility | | $3,801.89 | $7,244.36 | $15,135.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $138.04 / $269.15 / $562.34
| Professional | | $138.04 | $269.15 | $562.34 |