- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $223.87 / $3,388.44 / $5,888.44
| Facility | | $223.87 | $3,388.44 | $5,888.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $223.87 / $2,454.71 / $6,760.83
| Professional | | $223.87 | $2,454.71 | $6,760.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,606.93 / $10,964.78 / $18,197.01
| Facility | | $6,606.93 | $10,964.78 | $18,197.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $302.00 / $2,041.74 / $10,715.19
| Professional | | $302.00 | $2,041.74 | $10,715.19 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7,585.78 / $8,912.51 / $14,125.38
| Facility | | $7,585.78 | $8,912.51 | $14,125.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $338.84 / $794.33 / $8,709.64
| Professional | | $338.84 | $794.33 | $8,709.64 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $263.03 / $4,168.69 / $7,413.10
| Facility | | $263.03 | $4,168.69 | $7,413.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $512.86 / $741.31 / $7,943.28
| Professional | | $512.86 | $741.31 | $7,943.28 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $263.03 / $7,585.78 / $15,848.93
| Facility | | $263.03 | $7,585.78 | $15,848.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,454.71 / $5,754.40 / $16,218.10
| Professional | | $2,454.71 | $5,754.40 | $16,218.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $70.79
| Professional | | $32.36 | $33.11 | $70.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $346.74 / $9,332.54 / $10,471.29
| Facility | | $346.74 | $9,332.54 | $10,471.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $323.59 / $3,890.45 / $6,760.83
| Professional | | $323.59 | $3,890.45 | $6,760.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $331.13 / $2,951.21 / $8,709.64
| Professional | | $331.13 | $2,951.21 | $8,709.64 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16,218.10 / $16,218.10 / $23,988.33
| Facility | | $16,218.10 | $16,218.10 | $23,988.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $354.81 / $5,248.07 / $19,054.61
| Professional | | $354.81 | $5,248.07 | $19,054.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $660.69 / $660.69 / $8,317.64
| Professional | | $660.69 | $660.69 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $741.31 / $1,348.96 / $15,848.93
| Professional | | $741.31 | $1,348.96 | $15,848.93 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7,585.78 / $12,022.64 / $15,848.93
| Facility | | $7,585.78 | $12,022.64 | $15,848.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $288.40 / $2,570.40 / $12,302.69
| Professional | | $288.40 | $2,570.40 | $12,302.69 |