- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $467.74 / $891.25 / $14,454.40
| Facility | | $467.74 | $891.25 | $14,454.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $398.11 / $489.78 / $1,071.52
| Professional | | $398.11 | $489.78 | $1,071.52 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9,120.11 / $12,882.50 / $22,387.21
| Facility | | $9,120.11 | $12,882.50 | $22,387.21 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $416.87 / $831.76 / $1,949.84
| Professional | | $416.87 | $831.76 | $1,949.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,122.02 / $1,318.26 / $2,089.30
| Facility | | $1,122.02 | $1,318.26 | $2,089.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $478.63 / $1,380.38 / $1,548.82
| Professional | | $478.63 | $1,380.38 | $1,548.82 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $478.63 / $7,413.10 / $13,489.63
| Facility | | $478.63 | $7,413.10 | $13,489.63 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $776.25 / $1,071.52 / $1,348.96
| Professional | | $776.25 | $1,071.52 | $1,348.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $501.19 / $9,772.37 / $16,595.87
| Facility | | $501.19 | $9,772.37 | $16,595.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $426.58 / $758.58 / $2,290.87
| Professional | | $426.58 | $758.58 | $2,290.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $575.44
| Professional | | $32.36 | $33.11 | $575.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $851.14 / $10,715.19 / $17,378.01
| Facility | | $851.14 | $10,715.19 | $17,378.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $588.84 / $1,096.48 / $1,412.54
| Professional | | $588.84 | $1,096.48 | $1,412.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $512.86 / $1,000.00 / $1,380.38
| Professional | | $512.86 | $1,000.00 | $1,380.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10,964.78 / $16,218.10 / $16,218.10
| Facility | | $10,964.78 | $16,218.10 | $16,218.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $588.84 / $2,089.30 / $3,162.28
| Professional | | $588.84 | $2,089.30 | $3,162.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,174.90 / $1,174.90 / $1,174.90
| Professional | | $1,174.90 | $1,174.90 | $1,174.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,318.26 / $2,089.30 / $2,089.30
| Professional | | $1,318.26 | $2,089.30 | $2,089.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8,912.51 / $14,125.38 / $17,378.01
| Facility | | $8,912.51 | $14,125.38 | $17,378.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $398.11 / $691.83 / $1,905.46
| Professional | | $398.11 | $691.83 | $1,905.46 |