- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,047.13 / $3,801.89 / $9,120.11
| Facility | | $1,047.13 | $3,801.89 | $9,120.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $691.83 / $954.99 / $2,630.27
| Professional | | $691.83 | $954.99 | $2,630.27 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,388.44 / $5,495.41 / $12,882.50
| Facility | | $3,388.44 | $5,495.41 | $12,882.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $575.44 / $758.58 / $1,905.46
| Professional | | $575.44 | $758.58 | $1,905.46 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,202.26 / $1,698.24 / $6,165.95
| Facility | | $1,202.26 | $1,698.24 | $6,165.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,202.26 / $1,202.26 / $1,202.26
| Professional | | $1,202.26 | $1,202.26 | $1,202.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,380.38 / $2,187.76 / $53,703.18
| Facility | | $1,380.38 | $2,187.76 | $53,703.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $630.96 / $1,071.52 / $3,311.31
| Professional | | $630.96 | $1,071.52 | $3,311.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $812.83 / $977.24 / $2,951.21
| Facility | | $812.83 | $977.24 | $2,951.21 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $870.96 / $1,071.52 / $1,621.81
| Professional | | $870.96 | $1,071.52 | $1,621.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $602.56 / $1,023.29 / $1,819.70
| Professional | | $602.56 | $1,023.29 | $1,819.70 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $707.95 / $50,118.72 / $75,857.76
| Facility | | $707.95 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $398.11 / $977.24 / $1,778.28
| Professional | | $398.11 | $977.24 | $1,778.28 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,344.23 / $4,786.30 / $10,232.93
| Facility | | $2,344.23 | $4,786.30 | $10,232.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $660.69 / $977.24 / $2,398.83
| Professional | | $660.69 | $977.24 | $2,398.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $707.95 / $1,174.90 / $2,187.76
| Facility | | $707.95 | $1,174.90 | $2,187.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $630.96 / $1,023.29 / $3,235.94
| Professional | | $630.96 | $1,023.29 | $3,235.94 |