- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $229.09 / $2,238.72 / $5,128.61
| Facility | | $229.09 | $2,238.72 | $5,128.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $173.78 / $426.58 / $3,019.95
| Professional | | $173.78 | $426.58 | $3,019.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $758.58 / $7,413.10 / $20,892.96
| Facility | | $758.58 | $7,413.10 | $20,892.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $239.88 / $912.01 / $7,079.46
| Professional | | $239.88 | $912.01 | $7,079.46 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $380.19 / $380.19 / $891.25
| Facility | | $380.19 | $380.19 | $891.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $489.78 / $2,238.72 / $4,365.16
| Professional | | $489.78 | $2,238.72 | $4,365.16 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $213.80 / $616.60 / $4,897.79
| Professional | | $213.80 | $616.60 | $4,897.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $295.12 / $407.38 / $3,311.31
| Facility | | $295.12 | $407.38 | $3,311.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,454.71 / $3,090.30 / $4,073.80
| Professional | | $2,454.71 | $3,090.30 | $4,073.80 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,090.30 / $6,918.31 / $47,863.01
| Facility | | $3,090.30 | $6,918.31 | $47,863.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $354.81 / $1,380.38 / $5,754.40
| Professional | | $354.81 | $1,380.38 | $5,754.40 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,949.84 / $9,549.93 / $9,772.37
| Facility | | $1,949.84 | $9,549.93 | $9,772.37 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $758.58 / $7,413.10 / $20,892.96
| Facility | | $758.58 | $7,413.10 | $20,892.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $239.88 / $912.01 / $7,079.46
| Professional | | $239.88 | $912.01 | $7,079.46 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,570.40 / $6,165.95 / $36,307.81
| Facility | | $2,570.40 | $6,165.95 | $36,307.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $223.87 / $776.25 / $5,888.44
| Professional | | $223.87 | $776.25 | $5,888.44 |