- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $537.03 / $1,698.24 / $2,511.89
| Facility | | $537.03 | $1,698.24 | $2,511.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $426.58 / $537.03 / $1,412.54
| Professional | | $426.58 | $537.03 | $1,412.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7,079.46 / $16,595.87 / $20,892.96
| Facility | | $7,079.46 | $16,595.87 | $20,892.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $501.19 / $616.60 / $977.24
| Professional | | $501.19 | $616.60 | $977.24 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $154.88 / $208.93 / $363.08
| Facility | | $154.88 | $208.93 | $363.08 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $575.44 / $616.60 / $933.25
| Professional | | $575.44 | $616.60 | $933.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $512.86 / $870.96 / $1,995.26
| Facility | | $512.86 | $870.96 | $1,995.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $501.19 / $630.96 / $1,047.13
| Professional | | $501.19 | $630.96 | $1,047.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $524.81 / $794.33 / $1,819.70
| Facility | | $524.81 | $794.33 | $1,819.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $467.74 / $660.69 / $3,388.44
| Professional | | $467.74 | $660.69 | $3,388.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $436.52 / $436.52 / $1,122.02
| Facility | | $436.52 | $436.52 | $1,122.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $478.63 / $588.84 / $1,023.29
| Professional | | $478.63 | $588.84 | $1,023.29 |