- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $489.78 / $9,120.11 / $20,892.96
| Facility | | $489.78 | $9,120.11 | $20,892.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $245.47 / $338.84 / $691.83
| Professional | | $245.47 | $338.84 | $691.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,606.93 / $9,332.54 / $19,054.61
| Facility | | $6,606.93 | $9,332.54 | $19,054.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $354.81 / $501.19 / $660.69
| Professional | | $354.81 | $501.19 | $660.69 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,890.45 / $3,890.45 / $3,890.45
| Facility | | $3,890.45 | $3,890.45 | $3,890.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $323.59 / $489.78 / $776.25
| Professional | | $323.59 | $489.78 | $776.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $346.74 / $616.60 / $9,549.93
| Facility | | $346.74 | $616.60 | $9,549.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $331.13 / $575.44 / $3,090.30
| Professional | | $331.13 | $575.44 | $3,090.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $56.23
| Professional | | $32.36 | $33.11 | $56.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $338.84 / $512.86 / $512.86
| Facility | | $338.84 | $512.86 | $512.86 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $346.74 / $346.74 / $354.81
| Facility | | $346.74 | $346.74 | $354.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $354.81 / $549.54 / $758.58
| Professional | | $354.81 | $549.54 | $758.58 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,456.54 / $9,549.93 / $19,054.61
| Facility | | $6,456.54 | $9,549.93 | $19,054.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $354.81 / $512.86 / $707.95
| Professional | | $354.81 | $512.86 | $707.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,691.53 / $10,964.78 / $19,952.62
| Facility | | $2,691.53 | $10,964.78 | $19,952.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $275.42 / $416.87 / $741.31
| Professional | | $275.42 | $416.87 | $741.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $245.47 / $309.03 / $467.74
| Professional | | $245.47 | $309.03 | $467.74 |