- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,454.71 / $6,456.54 / $16,982.44
| Facility | | $2,454.71 | $6,456.54 | $16,982.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $389.05 / $489.78 / $1,905.46
| Professional | | $389.05 | $489.78 | $1,905.46 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,570.88 / $8,128.31 / $15,848.93
| Facility | | $4,570.88 | $8,128.31 | $15,848.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $501.19 / $707.95 / $1,412.54
| Professional | | $501.19 | $707.95 | $1,412.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $83.18 / $4,897.79 / $9,332.54
| Facility | | $83.18 | $4,897.79 | $9,332.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $457.09 / $691.83 / $1,412.54
| Professional | | $457.09 | $691.83 | $1,412.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $426.58 / $562.34 / $1,288.25
| Professional | | $426.58 | $562.34 | $1,288.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $316.23 / $457.09 / $575.44
| Professional | | $316.23 | $457.09 | $575.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $389.05 / $512.86 / $954.99
| Professional | | $389.05 | $512.86 | $954.99 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $54.95 / $56.23 / $4,786.30
| Facility | | $54.95 | $56.23 | $4,786.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,235.94 / $4,073.80 / $4,073.80
| Professional | | $3,235.94 | $4,073.80 | $4,073.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $691.83 / $691.83 / $691.83
| Professional | | $691.83 | $691.83 | $691.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $436.52 / $588.84 / $891.25
| Facility | | $436.52 | $588.84 | $891.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $407.38 / $549.54 / $1,202.26
| Professional | | $407.38 | $549.54 | $1,202.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,445.44 / $1,445.44 / $1,445.44
| Professional | | $1,445.44 | $1,445.44 | $1,445.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $316.23 / $416.87 / $537.03
| Professional | | $316.23 | $416.87 | $537.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,949.84 / $6,165.95 / $18,620.87
| Facility | | $1,949.84 | $6,165.95 | $18,620.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $371.54 / $524.81 / $1,318.26
| Professional | | $371.54 | $524.81 | $1,318.26 |