- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $588.84 / $3,162.28 / $8,128.31
| Facility | | $588.84 | $3,162.28 | $8,128.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $389.05 / $524.81 / $1,318.26
| Professional | | $389.05 | $524.81 | $1,318.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,630.27 / $4,786.30 / $9,772.37
| Facility | | $2,630.27 | $4,786.30 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $354.81 / $467.74 / $1,202.26
| Professional | | $354.81 | $467.74 | $1,202.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $575.44 / $1,698.24 / $6,165.95
| Facility | | $575.44 | $1,698.24 | $6,165.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $575.44 / $575.44 / $645.65
| Professional | | $575.44 | $575.44 | $645.65 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $676.08 / $1,862.09 / $53,703.18
| Facility | | $676.08 | $1,862.09 | $53,703.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $371.54 / $616.60 / $1,548.82
| Professional | | $371.54 | $616.60 | $1,548.82 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $389.05 / $489.78 / $1,380.38
| Facility | | $389.05 | $489.78 | $1,380.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $478.63 / $660.69 / $977.24
| Professional | | $478.63 | $660.69 | $977.24 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $323.59 / $562.34 / $977.24
| Professional | | $323.59 | $562.34 | $977.24 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $436.52 / $50,118.72 / $75,857.76
| Facility | | $436.52 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $398.11 / $562.34 / $954.99
| Professional | | $398.11 | $562.34 | $954.99 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,041.74 / $3,981.07 / $8,709.64
| Facility | | $2,041.74 | $3,981.07 | $8,709.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $338.84 / $501.19 / $1,202.26
| Professional | | $338.84 | $501.19 | $1,202.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $331.13 / $562.34 / $1,258.93
| Facility | | $331.13 | $562.34 | $1,258.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $331.13 / $562.34 / $1,659.59
| Professional | | $331.13 | $562.34 | $1,659.59 |