- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $173.78 / $2,754.23 / $14,454.40
| Facility | | $173.78 | $2,754.23 | $14,454.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $173.78 / $691.83 / $2,238.72
| Professional | | $173.78 | $691.83 | $2,238.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,311.31 / $4,786.30 / $7,585.78
| Facility | | $3,311.31 | $4,786.30 | $7,585.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $275.42 / $891.25 / $2,884.03
| Professional | | $275.42 | $891.25 | $2,884.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,041.74 / $2,344.23 / $3,801.89
| Facility | | $2,041.74 | $2,344.23 | $3,801.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $251.19 / $616.60 / $2,511.89
| Professional | | $251.19 | $616.60 | $2,511.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $199.53 / $1,479.11 / $4,265.80
| Facility | | $199.53 | $1,479.11 | $4,265.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $371.54 / $575.44 / $2,089.30
| Professional | | $371.54 | $575.44 | $2,089.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $199.53 / $3,981.07 / $8,709.64
| Facility | | $199.53 | $3,981.07 | $8,709.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $724.44 / $1,412.54 / $4,466.84
| Professional | | $724.44 | $1,412.54 | $4,466.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $602.56
| Professional | | $32.36 | $33.11 | $602.56 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $346.74 / $5,754.40 / $7,762.47
| Facility | | $346.74 | $5,754.40 | $7,762.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $457.09 / $1,096.48 / $2,511.89
| Professional | | $457.09 | $1,096.48 | $2,511.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $295.12 / $812.83 / $2,511.89
| Professional | | $295.12 | $812.83 | $2,511.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,309.57 / $9,332.54 / $9,332.54
| Facility | | $6,309.57 | $9,332.54 | $9,332.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $257.04 / $2,187.76 / $8,912.51
| Professional | | $257.04 | $2,187.76 | $8,912.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $891.25 / $891.25 / $4,073.80
| Professional | | $891.25 | $891.25 | $4,073.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $758.58 / $1,348.96 / $4,466.84
| Professional | | $758.58 | $1,348.96 | $4,466.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,897.79 / $7,585.78 / $9,120.11
| Facility | | $4,897.79 | $7,585.78 | $9,120.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $223.87 / $758.58 / $2,691.53
| Professional | | $223.87 | $758.58 | $2,691.53 |