- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,819.70 / $3,388.44 / $6,165.95
| Facility | | $1,819.70 | $3,388.44 | $6,165.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $245.47 / $977.24 / $4,466.84
| Professional | | $245.47 | $977.24 | $4,466.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $588.84 / $6,309.57 / $50,118.72
| Facility | | $588.84 | $6,309.57 | $50,118.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $263.03 / $1,698.24 / $6,456.54
| Professional | | $263.03 | $1,698.24 | $6,456.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $281.84 / $281.84 / $660.69
| Facility | | $281.84 | $281.84 | $660.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $478.63 / $758.58 / $6,760.83
| Professional | | $478.63 | $758.58 | $6,760.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $309.03 / $912.01 / $5,888.44
| Professional | | $309.03 | $912.01 | $5,888.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $131.83 / $281.84 / $3,311.31
| Facility | | $131.83 | $281.84 | $3,311.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,258.93 / $2,344.23 / $3,467.37
| Professional | | $1,258.93 | $2,344.23 | $3,467.37 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,398.83 / $5,248.07 / $11,220.18
| Facility | | $2,398.83 | $5,248.07 | $11,220.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $263.03 / $2,041.74 / $5,248.07
| Professional | | $263.03 | $2,041.74 | $5,248.07 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,365.16 / $5,370.32 / $14,125.38
| Facility | | $4,365.16 | $5,370.32 | $14,125.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $851.14 / $851.14 / $851.14
| Professional | | $851.14 | $851.14 | $851.14 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $588.84 / $6,309.57 / $50,118.72
| Facility | | $588.84 | $6,309.57 | $50,118.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $263.03 / $1,698.24 / $6,456.54
| Professional | | $263.03 | $1,698.24 | $6,456.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,238.72 / $5,248.07 / $12,022.64
| Facility | | $2,238.72 | $5,248.07 | $12,022.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $323.59 / $1,949.84 / $5,370.32
| Professional | | $323.59 | $1,949.84 | $5,370.32 |