- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $870.96 / $3,630.78 / $12,022.64
| Facility | | $870.96 | $3,630.78 | $12,022.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $380.19 / $467.74 / $758.58
| Professional | | $380.19 | $467.74 | $758.58 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,137.96 / $3,981.07 / $7,585.78
| Facility | | $2,137.96 | $3,981.07 | $7,585.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $398.11 / $501.19 / $676.08
| Professional | | $398.11 | $501.19 | $676.08 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $380.19 / $380.19 / $380.19
| Facility | | $380.19 | $380.19 | $380.19 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,398.83 / $2,398.83 / $2,398.83
| Facility | | $2,398.83 | $2,398.83 | $2,398.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $436.52 / $575.44 / $912.01
| Professional | | $436.52 | $575.44 | $912.01 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9,772.37 / $45,708.82 / $45,708.82
| Facility | | $9,772.37 | $45,708.82 | $45,708.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4,466.84 / $4,466.84 / $4,466.84
| Professional | | $4,466.84 | $4,466.84 | $4,466.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $416.87 / $812.83 / $4,786.30
| Facility | | $416.87 | $812.83 | $4,786.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $407.38 / $588.84 / $912.01
| Professional | | $407.38 | $588.84 | $912.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $346.74
| Professional | | $32.36 | $33.11 | $346.74 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $831.76 / $1,122.02
| Professional | | $6.03 | $831.76 | $1,122.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $389.05 / $524.81 / $954.99
| Facility | | $389.05 | $524.81 | $954.99 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $426.58 / $575.44 / $912.01
| Professional | | $426.58 | $575.44 | $912.01 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,445.44 / $3,630.78 / $7,244.36
| Facility | | $1,445.44 | $3,630.78 | $7,244.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $346.74 / $467.74 / $758.58
| Professional | | $346.74 | $467.74 | $758.58 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $380.19 / $407.38 / $407.38
| Professional | | $380.19 | $407.38 | $407.38 |