- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $416.87 / $933.25 / $14,454.40
| Facility | | $416.87 | $933.25 | $14,454.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $398.11 / $446.68 / $1,148.15
| Professional | | $398.11 | $446.68 | $1,148.15 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,311.31 / $4,786.30 / $7,585.78
| Facility | | $3,311.31 | $4,786.30 | $7,585.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $457.09 / $870.96 / $2,187.76
| Professional | | $457.09 | $870.96 | $2,187.76 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,202.26 / $1,380.38 / $2,238.72
| Facility | | $1,202.26 | $1,380.38 | $2,238.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $575.44 / $1,778.28 / $2,041.74
| Professional | | $575.44 | $1,778.28 | $2,041.74 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $436.52 / $933.25 / $4,168.69
| Facility | | $436.52 | $933.25 | $4,168.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $812.83 / $1,096.48 / $1,412.54
| Professional | | $812.83 | $1,096.48 | $1,412.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $446.68 / $933.25 / $5,623.41
| Facility | | $446.68 | $933.25 | $5,623.41 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $478.63 / $812.83 / $3,981.07
| Professional | | $478.63 | $812.83 | $3,981.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $70.79
| Professional | | $32.36 | $33.11 | $70.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $954.99 / $3,890.45 / $4,570.88
| Facility | | $954.99 | $3,890.45 | $4,570.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $562.34 / $1,096.48 / $1,949.84
| Professional | | $562.34 | $1,096.48 | $1,949.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $660.69 / $1,000.00 / $1,445.44
| Professional | | $660.69 | $1,000.00 | $1,445.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,905.46 / $3,548.13 / $5,248.07
| Facility | | $1,905.46 | $3,548.13 | $5,248.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $870.96 / $2,238.72 / $3,981.07
| Professional | | $870.96 | $2,238.72 | $3,981.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,584.89 / $1,584.89 / $1,584.89
| Professional | | $1,584.89 | $1,584.89 | $1,584.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,412.54 / $2,630.27 / $2,951.21
| Professional | | $1,412.54 | $2,630.27 | $2,951.21 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,884.03 / $3,548.13 / $6,918.31
| Facility | | $2,884.03 | $3,548.13 | $6,918.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $457.09 / $691.83 / $1,905.46
| Professional | | $457.09 | $691.83 | $1,905.46 |