- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $741.31 / $3,388.44 / $5,370.32
| Facility | | $741.31 | $3,388.44 | $5,370.32 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $537.03 / $794.33 / $1,412.54
| Professional | | $537.03 | $794.33 | $1,412.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,288.25 / $3,981.07 / $11,220.18
| Facility | | $1,288.25 | $3,981.07 | $11,220.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $524.81 / $891.25 / $2,238.72
| Professional | | $524.81 | $891.25 | $2,238.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $645.65 / $645.65 / $1,445.44
| Facility | | $645.65 | $645.65 | $1,445.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $645.65 / $1,096.48 / $1,659.59
| Professional | | $645.65 | $1,096.48 | $1,659.59 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $1,288.25 / $1,995.26 / $1,995.26
| Professional | 50 | $1,288.25 | $1,995.26 | $1,995.26 |
- 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
- $501.19 / $1,071.52 / $2,041.74
| Professional | | $501.19 | $1,071.52 | $2,041.74 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $489.78 / $707.95 / $4,897.79
| Facility | | $489.78 | $707.95 | $4,897.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $851.14 / $1,023.29 / $1,318.26
| Professional | | $851.14 | $1,023.29 | $1,318.26 |
- 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
- $562.34 / $912.01 / $1,949.84
| Professional | | $562.34 | $912.01 | $1,949.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $758.58 / $1,174.90 / $1,778.28
| Professional | | $758.58 | $1,174.90 | $1,778.28 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,288.25 / $3,981.07 / $11,220.18
| Facility | | $1,288.25 | $3,981.07 | $11,220.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $524.81 / $891.25 / $2,238.72
| Professional | | $524.81 | $891.25 | $2,238.72 |
- 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
- $562.34 / $954.99 / $1,995.26
| Professional | | $562.34 | $954.99 | $1,995.26 |