- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $549.54 / $758.58 / $1,905.46
| Facility | | $549.54 | $758.58 | $1,905.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $346.74 / $416.87 / $707.95
| Professional | | $346.74 | $416.87 | $707.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,630.27 / $4,570.88 / $7,079.46
| Facility | | $2,630.27 | $4,570.88 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $380.19 / $707.95 / $1,778.28
| Professional | | $380.19 | $707.95 | $1,778.28 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,023.29 / $1,202.26 / $1,905.46
| Facility | | $1,023.29 | $1,202.26 | $1,905.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $426.58 / $933.25 / $1,445.44
| Professional | | $426.58 | $933.25 | $1,445.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $354.81 / $645.65 / $3,548.13
| Facility | | $354.81 | $645.65 | $3,548.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $676.08 / $977.24 / $1,148.15
| Professional | | $676.08 | $977.24 | $1,148.15 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $354.81 / $676.08 / $8,128.31
| Facility | | $354.81 | $676.08 | $8,128.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $398.11 / $831.76 / $2,884.03
| Professional | | $398.11 | $831.76 | $2,884.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $512.86
| Professional | | $32.36 | $33.11 | $512.86 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $776.25 / $5,754.40 / $7,762.47
| Facility | | $776.25 | $5,754.40 | $7,762.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $537.03 / $1,148.15 / $1,621.81
| Professional | | $537.03 | $1,148.15 | $1,621.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $501.19 / $912.01 / $1,288.25
| Professional | | $501.19 | $912.01 | $1,288.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $954.99 / $2,951.21 / $2,951.21
| Facility | | $954.99 | $2,951.21 | $2,951.21 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $588.84 / $1,778.28 / $2,818.38
| Professional | | $588.84 | $1,778.28 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,737.80 / $1,737.80 / $1,819.70
| Professional | | $1,737.80 | $1,737.80 | $1,819.70 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $660.69 / $660.69 / $660.69
| Facility | | $660.69 | $660.69 | $660.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,621.81 / $3,630.78 / $3,801.89
| Professional | | $1,621.81 | $3,630.78 | $3,801.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,786.30 / $7,413.10 / $9,120.11
| Facility | | $4,786.30 | $7,413.10 | $9,120.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $354.81 / $660.69 / $1,584.89
| Professional | | $354.81 | $660.69 | $1,584.89 |