- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $363.08 / $4,466.84 / $18,620.87
| Facility | | $363.08 | $4,466.84 | $18,620.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $177.83 / $269.15 / $1,071.52
| Professional | | $177.83 | $269.15 | $1,071.52 |
- 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
- $257.04 / $398.11 / $588.84
| Professional | | $257.04 | $398.11 | $588.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $478.63 / $478.63 / $3,801.89
| Facility | | $478.63 | $478.63 | $3,801.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $218.78 / $323.59 / $588.84
| Professional | | $218.78 | $323.59 | $588.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $251.19 / $489.78 / $4,570.88
| Facility | | $251.19 | $489.78 | $4,570.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $251.19 / $467.74 / $2,511.89
| Professional | | $251.19 | $467.74 | $2,511.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $112.20
| Professional | | $32.36 | $33.11 | $112.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $302.00 / $371.54 / $380.19
| Facility | | $302.00 | $371.54 | $380.19 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $251.19 / $251.19 / $263.03
| Facility | | $251.19 | $251.19 | $263.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $263.03 / $407.38 / $537.03
| Professional | | $263.03 | $407.38 | $537.03 |
- 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
- $257.04 / $398.11 / $602.56
| Professional | | $257.04 | $398.11 | $602.56 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,698.24 / $11,220.18 / $21,877.62
| Facility | | $1,698.24 | $11,220.18 | $21,877.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $213.80 / $281.84 / $512.86
| Professional | | $213.80 | $281.84 | $512.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $51.29 / $218.78 / $338.84
| Professional | | $51.29 | $218.78 | $338.84 |