- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,818.38 / $4,168.69 / $7,244.36
| Facility | | $2,818.38 | $4,168.69 | $7,244.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $524.81 / $2,630.27 / $3,981.07
| Professional | | $524.81 | $2,630.27 | $3,981.07 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,760.83 / $7,585.78 / $7,943.28
| Facility | | $6,760.83 | $7,585.78 | $7,943.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $194.98 / $269.15 / $1,148.15
| Professional | | $194.98 | $269.15 | $1,148.15 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $37.15 / $199.53 / $234.42
| Facility | | $37.15 | $199.53 | $234.42 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $457.09 / $1,047.13 / $5,128.61
| Facility | | $457.09 | $1,047.13 | $5,128.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $218.78 / $331.13 / $602.56
| Professional | | $218.78 | $331.13 | $602.56 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $208.93 / $426.58 / $5,128.61
| Facility | | $208.93 | $426.58 | $5,128.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $208.93 / $316.23 / $524.81
| Professional | | $208.93 | $316.23 | $524.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $109.65
| Professional | | $32.36 | $33.11 | $109.65 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,890.45 / $3,890.45 / $3,890.45
| Facility | | $3,890.45 | $3,890.45 | $3,890.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $234.42 / $295.12 / $524.81
| Professional | | $234.42 | $295.12 | $524.81 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $204.17 / $2,398.83 / $7,244.36
| Facility | | $204.17 | $2,398.83 | $7,244.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $251.19 / $1,445.44 / $3,235.94
| Professional | | $251.19 | $1,445.44 | $3,235.94 |