- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $575.44 / $4,786.30 / $8,317.64
| Facility | | $575.44 | $4,786.30 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $398.11 / $467.74 / $933.25
| Professional | | $398.11 | $467.74 | $933.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,090.30 / $3,981.07 / $4,466.84
| Facility | | $3,090.30 | $3,981.07 | $4,466.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $389.05 / $524.81 / $741.31
| Professional | | $389.05 | $524.81 | $741.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $446.68 / $1,513.56 / $2,754.23
| Professional | | $446.68 | $1,513.56 | $2,754.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $371.54 / $524.81 / $851.14
| Professional | | $371.54 | $524.81 | $851.14 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $371.54 / $446.68 / $1,148.15
| Professional | | $371.54 | $446.68 | $1,148.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $524.81 / $660.69 / $954.99
| Professional | | $524.81 | $660.69 | $954.99 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $407.38 / $588.84 / $870.96
| Facility | | $407.38 | $588.84 | $870.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $380.19 / $549.54 / $8,709.64
| Facility | | $380.19 | $549.54 | $8,709.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $380.19 / $549.54 / $8,709.64
| Professional | | $380.19 | $549.54 | $8,709.64 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,630.78 / $6,165.95 / $12,882.50
| Facility | | $3,630.78 | $6,165.95 | $12,882.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $346.74 / $512.86 / $831.76
| Professional | | $346.74 | $512.86 | $831.76 |