- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,041.74 / $4,677.35 / $8,317.64
| Facility | | $2,041.74 | $4,677.35 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $758.58 / $1,071.52 / $2,454.71
| Professional | | $758.58 | $1,071.52 | $2,454.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $933.25 / $933.25 / $933.25
| Professional | | $933.25 | $933.25 | $933.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $776.25 / $3,467.37 / $6,456.54
| Facility | | $776.25 | $3,467.37 | $6,456.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $812.83 / $954.99 / $4,677.35
| Professional | | $812.83 | $954.99 | $4,677.35 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $776.25 / $851.14 / $851.14
| Facility | | $776.25 | $851.14 | $851.14 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $741.31 / $933.25 / $1,949.84
| Professional | | $741.31 | $933.25 | $1,949.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $851.14 / $2,511.89 / $8,128.31
| Facility | | $851.14 | $2,511.89 | $8,128.31 |
- Facility/Professional
- Facility
- Modifier
- AS
- Typical Low / Median / Typical High
- $229.09 / $229.09 / $1,122.02
| Facility | AS | $229.09 | $229.09 | $1,122.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $758.58 / $977.24 / $7,585.78
| Professional | | $758.58 | $977.24 | $7,585.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,548.13 / $5,370.32 / $8,709.64
| Facility | | $3,548.13 | $5,370.32 | $8,709.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $741.31 / $891.25 / $1,584.89
| Professional | | $741.31 | $891.25 | $1,584.89 |