- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,023.29 / $5,370.32 / $8,511.38
| Facility | | $1,023.29 | $5,370.32 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $389.05 / $457.09 / $707.95
| Professional | | $389.05 | $457.09 | $707.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,801.89 / $4,466.84 / $57,543.99
| Facility | | $3,801.89 | $4,466.84 | $57,543.99 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $446.68 / $457.09 / $812.83
| Professional | | $446.68 | $457.09 | $812.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $676.08 / $676.08 / $676.08
| Facility | | $676.08 | $676.08 | $676.08 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $338.84 / $467.74 / $776.25
| Professional | | $338.84 | $467.74 | $776.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $562.34 / $562.34 / $776.25
| Professional | | $562.34 | $562.34 | $776.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $371.54 / $467.74 / $776.25
| Professional | | $371.54 | $467.74 | $776.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $831.76 / $4,168.69 / $8,317.64
| Facility | | $831.76 | $4,168.69 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $380.19 / $457.09 / $1,096.48
| Professional | | $380.19 | $457.09 | $1,096.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $467.74 / $501.19 / $1,047.13
| Professional | | $467.74 | $501.19 | $1,047.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $316.23 / $389.05 / $436.52
| Facility | | $316.23 | $389.05 | $436.52 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $316.23 / $389.05 / $467.74
| Professional | | $316.23 | $389.05 | $467.74 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,000.00 / $2,570.40 / $5,011.87
| Facility | | $1,000.00 | $2,570.40 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $346.74 / $457.09 / $794.33
| Professional | | $346.74 | $457.09 | $794.33 |