- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $870.96 / $5,754.40 / $8,511.38
| Facility | | $870.96 | $5,754.40 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $489.78 / $691.83 / $891.25
| Professional | | $489.78 | $691.83 | $891.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,011.87 / $8,511.38 / $77,624.71
| Facility | | $5,011.87 | $8,511.38 | $77,624.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $660.69 / $776.25 / $1,288.25
| Professional | | $660.69 | $776.25 | $1,288.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $489.78 / $794.33 / $1,174.90
| Facility | | $489.78 | $794.33 | $1,174.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $660.69 / $660.69 / $660.69
| Professional | | $660.69 | $660.69 | $660.69 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,621.81 / $1,621.81 / $1,621.81
| Facility | | $1,621.81 | $1,621.81 | $1,621.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $794.33 / $1,071.52 / $1,479.11
| Professional | | $794.33 | $1,071.52 | $1,479.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $707.95 / $851.14 / $1,318.26
| Professional | | $707.95 | $851.14 | $1,318.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $831.76 / $3,981.07 / $8,317.64
| Facility | | $831.76 | $3,981.07 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $478.63 / $691.83 / $933.25
| Professional | | $478.63 | $691.83 | $933.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.60 / $1,258.93 / $1,479.11
| Professional | | $0.60 | $1,258.93 | $1,479.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $588.84 / $588.84 / $741.31
| Facility | | $588.84 | $588.84 | $741.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $478.63 / $741.31 / $794.33
| Professional | | $478.63 | $741.31 | $794.33 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $398.11 / $2,290.87 / $6,309.57
| Facility | | $398.11 | $2,290.87 | $6,309.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $575.44 / $776.25 / $1,318.26
| Professional | | $575.44 | $776.25 | $1,318.26 |