- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $478.63 / $3,090.30 / $5,128.61
| Facility | | $478.63 | $3,090.30 | $5,128.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $331.13 / $489.78 / $831.76
| Professional | | $331.13 | $489.78 | $831.76 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $776.25 / $3,981.07 / $45,708.82
| Facility | | $776.25 | $3,981.07 | $45,708.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $338.84 / $588.84 / $1,479.11
| Professional | | $338.84 | $588.84 | $1,479.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $398.11 / $398.11 / $891.25
| Facility | | $398.11 | $398.11 | $891.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $691.83 / $1,348.96 / $1,348.96
| Professional | | $691.83 | $1,348.96 | $1,348.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,348.96 / $1,348.96 / $1,348.96
| Facility | | $1,348.96 | $1,348.96 | $1,348.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $309.03 / $691.83 / $1,258.93
| Professional | | $309.03 | $691.83 | $1,258.93 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $309.03 / $436.52 / $3,890.45
| Facility | | $309.03 | $436.52 | $3,890.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $562.34 / $676.08 / $870.96
| Professional | | $562.34 | $676.08 | $870.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,041.74 / $4,265.80 / $9,772.37
| Facility | | $2,041.74 | $4,265.80 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $354.81 / $588.84 / $1,288.25
| Professional | | $354.81 | $588.84 | $1,288.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $776.25 / $3,981.07 / $45,708.82
| Facility | | $776.25 | $3,981.07 | $45,708.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $338.84 / $588.84 / $1,479.11
| Professional | | $338.84 | $588.84 | $1,479.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,698.24 / $3,890.45 / $8,709.64
| Facility | | $1,698.24 | $3,890.45 | $8,709.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $346.74 / $602.56 / $1,318.26
| Professional | | $346.74 | $602.56 | $1,318.26 |