- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $707.95 / $6,025.60 / $18,620.87
| Facility | | $707.95 | $6,025.60 | $18,620.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $323.59 / $436.52 / $933.25
| Professional | | $323.59 | $436.52 | $933.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,754.40 / $8,317.64 / $16,982.44
| Facility | | $5,754.40 | $8,317.64 | $16,982.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $512.86 / $724.44 / $954.99
| Professional | | $512.86 | $724.44 | $954.99 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,398.83 / $2,398.83 / $3,981.07
| Facility | | $2,398.83 | $2,398.83 | $3,981.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $436.52 / $707.95 / $1,122.02
| Professional | | $436.52 | $707.95 | $1,122.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $489.78 / $891.25 / $8,511.38
| Facility | | $489.78 | $891.25 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $478.63 / $812.83 / $3,162.28
| Professional | | $478.63 | $812.83 | $3,162.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $56.23
| Professional | | $32.36 | $33.11 | $56.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $426.58 / $691.83 / $724.44
| Facility | | $426.58 | $691.83 | $724.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $501.19 / $501.19 / $512.86
| Facility | | $501.19 | $501.19 | $512.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $512.86 / $794.33 / $1,096.48
| Professional | | $512.86 | $794.33 | $1,096.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,165.95 / $8,709.64 / $16,982.44
| Facility | | $6,165.95 | $8,709.64 | $16,982.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $512.86 / $724.44 / $1,023.29
| Professional | | $512.86 | $724.44 | $1,023.29 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,691.53 / $10,232.93 / $18,620.87
| Facility | | $2,691.53 | $10,232.93 | $18,620.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $389.05 / $562.34 / $1,023.29
| Professional | | $389.05 | $562.34 | $1,023.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $363.08 / $446.68 / $676.08
| Professional | | $363.08 | $446.68 | $676.08 |