- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $831.76 / $3,630.78 / $12,022.64
| Facility | | $831.76 | $3,630.78 | $12,022.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $436.52 / $524.81 / $831.76
| Professional | | $436.52 | $524.81 | $831.76 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,495.41 / $10,471.29 / $20,417.38
| Facility | | $5,495.41 | $10,471.29 | $20,417.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $446.68 / $575.44 / $758.58
| Professional | | $446.68 | $575.44 | $758.58 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $436.52 / $436.52 / $436.52
| Facility | | $436.52 | $436.52 | $436.52 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,466.84 / $5,011.87 / $5,011.87
| Facility | | $4,466.84 | $5,011.87 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $467.74 / $645.65 / $1,023.29
| Professional | | $467.74 | $645.65 | $1,023.29 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,995.26 / $1,995.26 / $18,197.01
| Facility | | $1,995.26 | $1,995.26 | $18,197.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5,248.07 / $5,248.07 / $5,248.07
| Professional | | $5,248.07 | $5,248.07 | $5,248.07 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $478.63 / $831.76 / $4,786.30
| Facility | | $478.63 | $831.76 | $4,786.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $457.09 / $676.08 / $1,023.29
| Professional | | $457.09 | $676.08 | $1,023.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $398.11
| Professional | | $32.36 | $33.11 | $398.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $870.96 / $1,258.93
| Professional | | $3.98 | $870.96 | $1,258.93 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $446.68 / $588.84 / $1,096.48
| Facility | | $446.68 | $588.84 | $1,096.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $467.74 / $645.65 / $1,023.29
| Professional | | $467.74 | $645.65 | $1,023.29 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,238.72 / $6,165.95 / $12,022.64
| Facility | | $2,238.72 | $6,165.95 | $12,022.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $380.19 / $524.81 / $831.76
| Professional | | $380.19 | $524.81 | $831.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $436.52 / $457.09 / $457.09
| Professional | | $436.52 | $457.09 | $457.09 |