- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $512.86 / $933.25 / $1,659.59
| Facility | | $512.86 | $933.25 | $1,659.59 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $467.74 / $616.60 / $977.24
| Professional | | $467.74 | $616.60 | $977.24 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $457.09 / $562.34 / $1,122.02
| Professional | | $457.09 | $562.34 | $1,122.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $316.23 / $316.23 / $524.81
| Facility | | $316.23 | $316.23 | $524.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $316.23 / $524.81 / $851.14
| Professional | | $316.23 | $524.81 | $851.14 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,096.48 / $1,288.25 / $2,187.76
| Facility | | $1,096.48 | $1,288.25 | $2,187.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $457.09 / $851.14 / $2,398.83
| Professional | | $457.09 | $851.14 | $2,398.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $154.88 / $630.96 / $1,445.44
| Facility | | $154.88 | $630.96 | $1,445.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $812.83 / $1,174.90 / $1,584.89
| Professional | | $812.83 | $1,174.90 | $1,584.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $524.81 / $707.95 / $1,479.11
| Professional | | $524.81 | $707.95 | $1,479.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $213.80 / $50,118.72 / $75,857.76
| Facility | | $213.80 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $676.08 / $831.76 / $1,819.70
| Professional | | $676.08 | $831.76 | $1,819.70 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,258.93 / $1,819.70 / $2,454.71
| Facility | | $1,258.93 | $1,819.70 | $2,454.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $512.86 / $933.25 / $1,949.84
| Professional | | $512.86 | $933.25 | $1,949.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $363.08 / $812.83 / $1,174.90
| Facility | | $363.08 | $812.83 | $1,174.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $524.81 / $812.83 / $1,862.09
| Professional | | $524.81 | $812.83 | $1,862.09 |