- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $954.99 / $1,659.59 / $14,454.40
| Facility | | $954.99 | $1,659.59 | $14,454.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $691.83 / $912.01 / $2,089.30
| Professional | | $691.83 | $912.01 | $2,089.30 |
- 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
- $776.25 / $1,548.82 / $3,235.94
| Professional | | $776.25 | $1,548.82 | $3,235.94 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,089.30 / $2,454.71 / $3,890.45
| Facility | | $2,089.30 | $2,454.71 | $3,890.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $933.25 / $2,454.71 / $2,818.38
| Professional | | $933.25 | $2,454.71 | $2,818.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $933.25 / $2,570.40 / $4,786.30
| Facility | | $933.25 | $2,570.40 | $4,786.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,445.44 / $1,995.26 / $2,511.89
| Professional | | $1,445.44 | $1,995.26 | $2,511.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $977.24 / $5,623.41 / $8,709.64
| Facility | | $977.24 | $5,623.41 | $8,709.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $831.76 / $1,380.38 / $3,890.45
| Professional | | $831.76 | $1,380.38 | $3,890.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $1,096.48
| Professional | | $32.36 | $33.11 | $1,096.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,621.81 / $5,754.40 / $7,762.47
| Facility | | $1,621.81 | $5,754.40 | $7,762.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,122.02 / $2,041.74 / $2,570.40
| Professional | | $1,122.02 | $2,041.74 | $2,570.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,000.00 / $1,949.84 / $2,630.27
| Professional | | $1,000.00 | $1,949.84 | $2,630.27 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8,511.38 / $12,589.25 / $12,589.25
| Facility | | $8,511.38 | $12,589.25 | $12,589.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,148.15 / $3,890.45 / $6,025.60
| Professional | | $1,148.15 | $3,890.45 | $6,025.60 |
- 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
- $1,380.38 / $2,511.89 / $2,570.40
| Professional | | $1,380.38 | $2,511.89 | $2,570.40 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,897.79 / $7,585.78 / $9,772.37
| Facility | | $4,897.79 | $7,585.78 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $776.25 / $1,348.96 / $3,388.44
| Professional | | $776.25 | $1,348.96 | $3,388.44 |