- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $660.69 / $1,258.93 / $14,454.40
| Facility | | $660.69 | $1,258.93 | $14,454.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $575.44 / $660.69 / $1,548.82
| Professional | | $575.44 | $660.69 | $1,548.82 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,606.93 / $10,964.78 / $17,378.01
| Facility | | $6,606.93 | $10,964.78 | $17,378.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $575.44 / $1,174.90 / $2,818.38
| Professional | | $575.44 | $1,174.90 | $2,818.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,584.89 / $1,862.09 / $2,951.21
| Facility | | $1,584.89 | $1,862.09 | $2,951.21 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $691.83 / $1,778.28 / $2,089.30
| Professional | | $691.83 | $1,778.28 | $2,089.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $676.08 / $7,244.36 / $13,489.63
| Facility | | $676.08 | $7,244.36 | $13,489.63 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,096.48 / $1,513.56 / $1,862.09
| Professional | | $1,096.48 | $1,513.56 | $1,862.09 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $707.95 / $7,244.36 / $12,589.25
| Facility | | $707.95 | $7,244.36 | $12,589.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $588.84 / $1,047.13 / $2,951.21
| Professional | | $588.84 | $1,047.13 | $2,951.21 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $501.19
| Professional | | $32.36 | $33.11 | $501.19 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,202.26 / $8,511.38 / $9,120.11
| Facility | | $1,202.26 | $8,511.38 | $9,120.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $851.14 / $1,548.82 / $1,862.09
| Professional | | $851.14 | $1,548.82 | $1,862.09 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $707.95 / $1,380.38 / $1,905.46
| Professional | | $707.95 | $1,380.38 | $1,905.46 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7,244.36 / $10,964.78 / $10,964.78
| Facility | | $7,244.36 | $10,964.78 | $10,964.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $912.01 / $2,951.21 / $4,466.84
| Professional | | $912.01 | $2,951.21 | $4,466.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,513.56 / $1,513.56 / $1,513.56
| Professional | | $1,513.56 | $1,513.56 | $1,513.56 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,412.54 / $3,311.31 / $3,311.31
| Professional | | $1,412.54 | $3,311.31 | $3,311.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,606.93 / $10,232.93 / $12,589.25
| Facility | | $6,606.93 | $10,232.93 | $12,589.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $549.54 / $1,000.00 / $2,570.40
| Professional | | $549.54 | $1,000.00 | $2,570.40 |