- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $912.01 / $4,897.79 / $8,317.64
| Facility | | $912.01 | $4,897.79 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $724.44 / $851.14 / $1,778.28
| Professional | | $724.44 | $851.14 | $1,778.28 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,606.93 / $7,413.10 / $9,332.54
| Facility | | $6,606.93 | $7,413.10 | $9,332.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $794.33 / $1,174.90 / $2,041.74
| Professional | | $794.33 | $1,174.90 | $2,041.74 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $870.96 / $1,148.15 / $5,888.44
| Professional | | $870.96 | $1,148.15 | $5,888.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $645.65 / $645.65 / $645.65
| Facility | | $645.65 | $645.65 | $645.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $741.31 / $977.24 / $1,737.80
| Professional | | $741.31 | $977.24 | $1,737.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $724.44 / $912.01 / $1,096.48
| Professional | | $724.44 | $912.01 | $1,096.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,047.13 / $1,318.26 / $1,905.46
| Professional | | $1,047.13 | $1,318.26 | $1,905.46 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $758.58 / $1,023.29 / $1,548.82
| Facility | | $758.58 | $1,023.29 | $1,548.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,000.00 / $1,000.00 / $1,000.00
| Professional | | $1,000.00 | $1,000.00 | $1,000.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $741.31 / $1,047.13 / $9,549.93
| Facility | | $741.31 | $1,047.13 | $9,549.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $741.31 / $1,047.13 / $9,549.93
| Professional | | $741.31 | $1,047.13 | $9,549.93 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,309.57 / $10,471.29 / $21,379.62
| Facility | | $6,309.57 | $10,471.29 | $21,379.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $616.60 / $954.99 / $1,584.89
| Professional | | $616.60 | $954.99 | $1,584.89 |