- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $426.58 / $831.76 / $1,122.02
| Facility | | $426.58 | $831.76 | $1,122.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $323.59 / $436.52 / $1,122.02
| Professional | | $323.59 | $436.52 | $1,122.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,202.26 / $1,621.81 / $3,162.28
| Facility | | $1,202.26 | $1,621.81 | $3,162.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $562.34 / $870.96 / $1,318.26
| Professional | | $562.34 | $870.96 | $1,318.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,071.52 / $1,659.59 / $2,754.23
| Facility | | $1,071.52 | $1,659.59 | $2,754.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $467.74 / $812.83 / $1,348.96
| Professional | | $467.74 | $812.83 | $1,348.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $524.81 / $891.25 / $2,570.40
| Facility | | $524.81 | $891.25 | $2,570.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $524.81 / $891.25 / $1,148.15
| Professional | | $524.81 | $891.25 | $1,148.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $134.90
| Professional | | $32.36 | $33.11 | $134.90 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $275.42 / $407.38 / $851.14
| Facility | | $275.42 | $407.38 | $851.14 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $549.54 / $549.54 / $575.44
| Facility | | $549.54 | $549.54 | $575.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $575.44 / $891.25 / $1,202.26
| Professional | | $575.44 | $891.25 | $1,202.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,047.13 / $1,584.89 / $3,162.28
| Facility | | $1,047.13 | $1,584.89 | $3,162.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $562.34 / $870.96 / $1,318.26
| Professional | | $562.34 | $870.96 | $1,318.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $512.86 / $1,905.46 / $3,311.31
| Facility | | $512.86 | $1,905.46 | $3,311.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $363.08 / $512.86 / $1,023.29
| Professional | | $363.08 | $512.86 | $1,023.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $489.78 / $588.84 / $933.25
| Professional | | $489.78 | $588.84 | $933.25 |