- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $933.25 / $5,754.40 / $12,302.69
| Facility | | $933.25 | $5,754.40 | $12,302.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $257.04 / $354.81 / $776.25
| Professional | | $257.04 | $354.81 | $776.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $251.19 / $338.84 / $389.05
| Professional | | $251.19 | $338.84 | $389.05 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $954.99 / $3,630.78 / $12,302.69
| Facility | | $954.99 | $3,630.78 | $12,302.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $218.78 / $295.12 / $338.84
| Professional | | $218.78 | $295.12 | $338.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $489.78 / $1,659.59 / $1,949.84
| Facility | | $489.78 | $1,659.59 | $1,949.84 |
- Facility/Professional
- Facility
- Modifier
- 22
- Typical Low / Median / Typical High
- $588.84 / $588.84 / $588.84
| Facility | 22 | $588.84 | $588.84 | $588.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $257.04 / $380.19 / $630.96
| Professional | | $257.04 | $380.19 | $630.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,456.54 / $13,489.63 / $23,988.33
| Facility | | $6,456.54 | $13,489.63 | $23,988.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $186.21 / $199.53 / $338.84
| Professional | | $186.21 | $199.53 | $338.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $371.54
| Professional | | $32.36 | $33.11 | $371.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,737.80 / $5,495.41 / $9,772.37
| Facility | | $1,737.80 | $5,495.41 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $239.88 / $354.81 / $616.60
| Professional | | $239.88 | $354.81 | $616.60 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $218.78 / $218.78 / $295.12
| Professional | | $218.78 | $218.78 | $295.12 |