- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $676.08 / $3,801.89 / $9,120.11
| Facility | | $676.08 | $3,801.89 | $9,120.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $389.05 / $501.19 / $1,548.82
| Professional | | $389.05 | $501.19 | $1,548.82 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,388.44 / $5,495.41 / $12,882.50
| Facility | | $3,388.44 | $5,495.41 | $12,882.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $331.13 / $407.38 / $1,096.48
| Professional | | $331.13 | $407.38 | $1,096.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $588.84 / $588.84 / $588.84
| Facility | | $588.84 | $588.84 | $588.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $588.84 / $588.84 / $588.84
| Professional | | $588.84 | $588.84 | $588.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $34.67 / $4,365.16 / $53,703.18
| Facility | | $34.67 | $4,365.16 | $53,703.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $371.54 / $794.33 / $1,995.26
| Professional | | $371.54 | $794.33 | $1,995.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $457.09 / $562.34 / $1,621.81
| Facility | | $457.09 | $562.34 | $1,621.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $446.68 / $602.56 / $870.96
| Professional | | $446.68 | $602.56 | $870.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $363.08 / $562.34 / $1,202.26
| Professional | | $363.08 | $562.34 | $1,202.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $501.19 / $50,118.72 / $75,857.76
| Facility | | $501.19 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $501.19 / $602.56 / $1,258.93
| Professional | | $501.19 | $602.56 | $1,258.93 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,344.23 / $4,897.79 / $10,232.93
| Facility | | $2,344.23 | $4,897.79 | $10,232.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $263.03 / $616.60 / $1,412.54
| Professional | | $263.03 | $616.60 | $1,412.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $331.13 / $446.68 / $512.86
| Facility | | $331.13 | $446.68 | $512.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $363.08 / $512.86 / $1,202.26
| Professional | | $363.08 | $512.86 | $1,202.26 |