- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,047.13 / $1,737.80 / $7,413.10
| Facility | | $1,047.13 | $1,737.80 | $7,413.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $691.83 / $977.24 / $1,737.80
| Professional | | $691.83 | $977.24 | $1,737.80 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,047.13 / $1,548.82 / $2,089.30
| Facility | | $1,047.13 | $1,548.82 | $2,089.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $891.25 / $954.99 / $1,258.93
| Professional | | $891.25 | $954.99 | $1,258.93 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,096.48 / $2,398.83 / $2,754.23
| Facility | | $1,096.48 | $2,398.83 | $2,754.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $524.81 / $1,122.02 / $1,479.11
| Professional | | $524.81 | $1,122.02 | $1,479.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,047.13 / $1,318.26 / $3,630.78
| Facility | | $1,047.13 | $1,318.26 | $3,630.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,047.13 / $1,318.26 / $3,019.95
| Professional | | $1,047.13 | $1,318.26 | $3,019.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $64.57 / $75.86 / $75.86
| Professional | | $64.57 | $75.86 | $75.86 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,047.13 / $1,047.13 / $2,089.30
| Facility | | $1,047.13 | $1,047.13 | $2,089.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,047.13 / $1,047.13 / $1,148.15
| Professional | | $1,047.13 | $1,047.13 | $1,148.15 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,047.13 / $1,698.24 / $3,235.94
| Facility | | $1,047.13 | $1,698.24 | $3,235.94 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $954.99 / $954.99 / $1,288.25
| Professional | | $954.99 | $954.99 | $1,288.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,202.26 / $1,584.89 / $2,754.23
| Facility | | $1,202.26 | $1,584.89 | $2,754.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $851.14 / $954.99 / $1,288.25
| Professional | | $851.14 | $954.99 | $1,288.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $954.99 / $1,258.93 / $1,258.93
| Facility | | $954.99 | $1,258.93 | $1,258.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $436.52 / $436.52 / $1,174.90
| Professional | | $436.52 | $436.52 | $1,174.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $467.74 / $549.54 / $1,905.46
| Professional | | $467.74 | $549.54 | $1,905.46 |