- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $380.19 / $741.31 / $14,454.40
| Facility | | $380.19 | $741.31 | $14,454.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $331.13 / $407.38 / $891.25
| Professional | | $331.13 | $407.38 | $891.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,311.31 / $4,786.30 / $7,585.78
| Facility | | $3,311.31 | $4,786.30 | $7,585.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $346.74 / $676.08 / $1,621.81
| Professional | | $346.74 | $676.08 | $1,621.81 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $933.25 / $1,096.48 / $1,737.80
| Facility | | $933.25 | $1,096.48 | $1,737.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $398.11 / $1,148.15 / $1,288.25
| Professional | | $398.11 | $1,148.15 | $1,288.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $380.19 / $3,090.30 / $5,370.32
| Facility | | $380.19 | $3,090.30 | $5,370.32 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $645.65 / $891.25 / $1,096.48
| Professional | | $645.65 | $891.25 | $1,096.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $380.19 / $5,495.41 / $8,317.64
| Facility | | $380.19 | $5,495.41 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $354.81 / $691.83 / $1,862.09
| Professional | | $354.81 | $691.83 | $1,862.09 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $478.63
| Professional | | $32.36 | $33.11 | $478.63 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $707.95 / $5,754.40 / $7,762.47
| Facility | | $707.95 | $5,754.40 | $7,762.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $489.78 / $912.01 / $1,174.90
| Professional | | $489.78 | $912.01 | $1,174.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $426.58 / $831.76 / $1,148.15
| Professional | | $426.58 | $831.76 | $1,148.15 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,715.35 / $5,495.41 / $5,495.41
| Facility | | $3,715.35 | $5,495.41 | $5,495.41 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $489.78 / $1,737.80 / $2,630.27
| Professional | | $489.78 | $1,737.80 | $2,630.27 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $977.24 / $977.24 / $977.24
| Professional | | $977.24 | $977.24 | $977.24 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $467.74 / $1,737.80 / $1,737.80
| Professional | | $467.74 | $1,737.80 | $1,737.80 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,786.30 / $7,413.10 / $9,120.11
| Facility | | $4,786.30 | $7,413.10 | $9,120.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $331.13 / $575.44 / $1,548.82
| Professional | | $331.13 | $575.44 | $1,548.82 |