- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $467.74 / $870.96 / $14,454.40
| Facility | | $467.74 | $870.96 | $14,454.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $398.11 / $467.74 / $1,071.52
| Professional | | $398.11 | $467.74 | $1,071.52 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,311.31 / $4,897.79 / $8,709.64
| Facility | | $3,311.31 | $4,897.79 | $8,709.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $398.11 / $831.76 / $1,949.84
| Professional | | $398.11 | $831.76 | $1,949.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,122.02 / $1,288.25 / $2,089.30
| Facility | | $1,122.02 | $1,288.25 | $2,089.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $478.63 / $1,230.27 / $1,479.11
| Professional | | $478.63 | $1,230.27 | $1,479.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $467.74 / $7,244.36 / $13,489.63
| Facility | | $467.74 | $7,244.36 | $13,489.63 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $758.58 / $1,047.13 / $1,288.25
| Professional | | $758.58 | $1,047.13 | $1,288.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $489.78 / $5,623.41 / $8,317.64
| Facility | | $489.78 | $5,623.41 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $407.38 / $707.95 / $2,041.74
| Professional | | $407.38 | $707.95 | $2,041.74 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $537.03
| Professional | | $32.36 | $33.11 | $537.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $812.83 / $5,754.40 / $7,762.47
| Facility | | $812.83 | $5,754.40 | $7,762.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $575.44 / $1,071.52 / $1,258.93
| Professional | | $575.44 | $1,071.52 | $1,258.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $489.78 / $954.99 / $1,348.96
| Professional | | $489.78 | $954.99 | $1,348.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,456.54 / $9,549.93 / $9,549.93
| Facility | | $6,456.54 | $9,549.93 | $9,549.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $630.96 / $2,041.74 / $3,801.89
| Professional | | $630.96 | $2,041.74 | $3,801.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,047.13 / $1,047.13 / $1,047.13
| Professional | | $1,047.13 | $1,047.13 | $1,047.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,047.13 / $2,290.87 / $2,290.87
| Professional | | $1,047.13 | $2,290.87 | $2,290.87 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,897.79 / $7,585.78 / $9,120.11
| Facility | | $4,897.79 | $7,585.78 | $9,120.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $380.19 / $676.08 / $1,778.28
| Professional | | $380.19 | $676.08 | $1,778.28 |