- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $512.86 / $2,570.40 / $7,079.46
| Facility | | $512.86 | $2,570.40 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $416.87 / $512.86 / $776.25
| Professional | | $416.87 | $512.86 | $776.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,888.44 / $6,760.83 / $7,413.10
| Facility | | $5,888.44 | $6,760.83 | $7,413.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $426.58 / $562.34 / $812.83
| Professional | | $426.58 | $562.34 | $812.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $467.74 / $2,454.71 / $5,495.41
| Professional | | $467.74 | $2,454.71 | $5,495.41 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $407.38 / $575.44 / $954.99
| Professional | | $407.38 | $575.44 | $954.99 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $389.05 / $562.34 / $1,445.44
| Professional | | $389.05 | $562.34 | $1,445.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $549.54 / $676.08 / $1,071.52
| Professional | | $549.54 | $676.08 | $1,071.52 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $436.52 / $616.60 / $912.01
| Facility | | $436.52 | $616.60 | $912.01 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $389.05 / $575.44 / $8,709.64
| Facility | | $389.05 | $575.44 | $8,709.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $416.87 / $616.60 / $8,709.64
| Professional | | $416.87 | $616.60 | $8,709.64 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,630.78 / $6,025.60 / $12,882.50
| Facility | | $3,630.78 | $6,025.60 | $12,882.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $371.54 / $562.34 / $912.01
| Professional | | $371.54 | $562.34 | $912.01 |