- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $380.19 / $3,019.95 / $8,128.31
| Facility | | $380.19 | $3,019.95 | $8,128.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $257.04 / $524.81 / $1,230.27
| Professional | | $257.04 | $524.81 | $1,230.27 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,630.27 / $4,786.30 / $9,549.93
| Facility | | $2,630.27 | $4,786.30 | $9,549.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $380.19 / $501.19 / $1,288.25
| Professional | | $380.19 | $501.19 | $1,288.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $346.74 / $1,698.24 / $6,165.95
| Facility | | $346.74 | $1,698.24 | $6,165.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $346.74 / $346.74 / $776.25
| Professional | | $346.74 | $346.74 | $776.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $416.87 / $1,819.70 / $53,703.18
| Facility | | $416.87 | $1,819.70 | $53,703.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $275.42 / $660.69 / $1,737.80
| Professional | | $275.42 | $660.69 | $1,737.80 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $257.04 / $338.84 / $831.76
| Facility | | $257.04 | $338.84 | $831.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $549.54 / $741.31 / $1,071.52
| Professional | | $549.54 | $741.31 | $1,071.52 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $457.09 / $724.44 / $1,148.15
| Professional | | $457.09 | $724.44 | $1,148.15 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,995.26 / $1,995.26 / $1,995.26
| Facility | | $1,995.26 | $1,995.26 | $1,995.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $275.42 / $50,118.72 / $75,857.76
| Facility | | $275.42 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $398.11 / $691.83 / $1,122.02
| Professional | | $398.11 | $691.83 | $1,122.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,137.96 / $3,981.07 / $8,709.64
| Facility | | $2,137.96 | $3,981.07 | $8,709.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $223.87 / $549.54 / $1,318.26
| Professional | | $223.87 | $549.54 | $1,318.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $199.53 / $316.23 / $870.96
| Facility | | $199.53 | $316.23 | $870.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $436.52 / $691.83 / $1,148.15
| Professional | | $436.52 | $691.83 | $1,148.15 |