- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $263.03 / $2,884.03 / $17,782.79
| Facility | | $263.03 | $2,884.03 | $17,782.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $158.49 / $977.24 / $2,691.53
| Professional | | $158.49 | $977.24 | $2,691.53 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7,244.36 / $10,232.93 / $20,892.96
| Facility | | $7,244.36 | $10,232.93 | $20,892.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $213.80 / $501.19 / $2,951.21
| Professional | | $213.80 | $501.19 | $2,951.21 |
- 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
- $181.97 / $758.58 / $3,467.37
| Professional | | $181.97 | $758.58 | $3,467.37 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $245.47 / $1,513.56 / $3,388.44
| Facility | | $245.47 | $1,513.56 | $3,388.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $245.47 / $707.95 / $3,019.95
| Professional | | $245.47 | $707.95 | $3,019.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $33.11
| Professional | | $32.36 | $33.11 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,380.38 / $2,187.76 / $2,344.23
| Facility | | $1,380.38 | $2,187.76 | $2,344.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,584.89 / $1,584.89 / $1,584.89
| Facility | | $1,584.89 | $1,584.89 | $1,584.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $158.49 / $1,584.89 / $2,818.38
| Professional | | $158.49 | $1,584.89 | $2,818.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7,079.46 / $10,715.19 / $20,892.96
| Facility | | $7,079.46 | $10,715.19 | $20,892.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $223.87 / $501.19 / $2,951.21
| Professional | | $223.87 | $501.19 | $2,951.21 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,698.24 / $11,481.54 / $22,387.21
| Facility | | $1,698.24 | $11,481.54 | $22,387.21 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $208.93 / $1,148.15 / $2,570.40
| Professional | | $208.93 | $1,148.15 | $2,570.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $97.72 / $173.78 / $2,630.27
| Professional | | $97.72 | $173.78 | $2,630.27 |