- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,348.96 / $8,128.31 / $20,892.96
| Facility | | $1,348.96 | $8,128.31 | $20,892.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $616.60 / $891.25 / $1,778.28
| Professional | | $616.60 | $891.25 | $1,778.28 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,165.95 / $8,709.64 / $17,378.01
| Facility | | $6,165.95 | $8,709.64 | $17,378.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $954.99 / $1,380.38 / $1,905.46
| Professional | | $954.99 | $1,380.38 | $1,905.46 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $891.25 / $933.25 / $3,715.35
| Facility | | $891.25 | $933.25 | $3,715.35 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $660.69 / $1,174.90 / $2,089.30
| Professional | | $660.69 | $1,174.90 | $2,089.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $741.31 / $1,445.44 / $3,890.45
| Facility | | $741.31 | $1,445.44 | $3,890.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $691.83 / $1,380.38 / $2,951.21
| Professional | | $691.83 | $1,380.38 | $2,951.21 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $316.23
| Professional | | $32.36 | $33.11 | $316.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $831.76 / $1,348.96 / $1,380.38
| Facility | | $831.76 | $1,348.96 | $1,380.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $933.25 / $977.24 / $977.24
| Facility | | $933.25 | $977.24 | $977.24 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $977.24 / $1,412.54 / $1,819.70
| Professional | | $977.24 | $1,412.54 | $1,819.70 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,025.60 / $8,912.51 / $17,378.01
| Facility | | $6,025.60 | $8,912.51 | $17,378.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $954.99 / $1,380.38 / $1,862.09
| Professional | | $954.99 | $1,380.38 | $1,862.09 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,884.03 / $10,232.93 / $18,620.87
| Facility | | $2,884.03 | $10,232.93 | $18,620.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $707.95 / $1,000.00 / $1,819.70
| Professional | | $707.95 | $1,000.00 | $1,819.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $724.44 / $758.58 / $1,380.38
| Professional | | $724.44 | $758.58 | $1,380.38 |