- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $281.84 / $549.54 / $14,454.40
| Facility | | $281.84 | $549.54 | $14,454.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $245.47 / $295.12 / $660.69
| Professional | | $245.47 | $295.12 | $660.69 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,630.27 / $4,570.88 / $7,079.46
| Facility | | $2,630.27 | $4,570.88 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $263.03 / $501.19 / $1,202.26
| Professional | | $263.03 | $501.19 | $1,202.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $691.83 / $794.33 / $1,288.25
| Facility | | $691.83 | $794.33 | $1,288.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $331.13 / $851.14 / $954.99
| Professional | | $331.13 | $851.14 | $954.99 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $288.40 / $3,090.30 / $5,370.32
| Facility | | $288.40 | $3,090.30 | $5,370.32 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $467.74 / $660.69 / $812.83
| Professional | | $467.74 | $660.69 | $812.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $309.03 / $3,548.13 / $6,309.57
| Facility | | $309.03 | $3,548.13 | $6,309.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $269.15 / $501.19 / $1,412.54
| Professional | | $269.15 | $501.19 | $1,412.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $354.81
| Professional | | $32.36 | $33.11 | $354.81 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $524.81 / $3,890.45 / $4,570.88
| Facility | | $524.81 | $3,890.45 | $4,570.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $363.08 / $660.69 / $870.96
| Professional | | $363.08 | $660.69 | $870.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $194.98 / $363.08 / $812.83
| Professional | | $194.98 | $363.08 | $812.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,309.57 / $9,332.54 / $9,332.54
| Facility | | $6,309.57 | $9,332.54 | $9,332.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $363.08 / $1,288.25 / $3,162.28
| Professional | | $363.08 | $1,288.25 | $3,162.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $724.44 / $724.44 / $724.44
| Professional | | $724.44 | $724.44 | $724.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $707.95 / $1,202.26 / $1,288.25
| Professional | | $707.95 | $1,202.26 | $1,288.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,884.03 / $3,630.78 / $7,244.36
| Facility | | $2,884.03 | $3,630.78 | $7,244.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $223.87 / $436.52 / $1,148.15
| Professional | | $223.87 | $436.52 | $1,148.15 |