- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $549.54 / $10,232.93 / $28,183.83
| Facility | | $549.54 | $10,232.93 | $28,183.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $478.63 / $691.83 / $891.25
| Professional | | $478.63 | $691.83 | $891.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,023.29 / $1,318.26 / $1,778.28
| Professional | | $1,023.29 | $1,318.26 | $1,778.28 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $501.19 / $707.95 / $1,174.90
| Facility | | $501.19 | $707.95 | $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
- $707.95 / $1,148.15 / $1,819.70
| Facility | | $707.95 | $1,148.15 | $1,819.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $660.69 / $1,096.48 / $1,778.28
| Professional | | $660.69 | $1,096.48 | $1,778.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $33.11
| Professional | | $32.36 | $33.11 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $954.99 / $1,348.96 / $1,445.44
| Facility | | $954.99 | $1,348.96 | $1,445.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,023.29 / $1,023.29 / $1,047.13
| Facility | | $1,023.29 | $1,023.29 | $1,047.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,047.13 / $1,445.44 / $2,187.76
| Professional | | $1,047.13 | $1,445.44 | $2,187.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,047.13 / $1,348.96 / $1,737.80
| Professional | | $1,047.13 | $1,348.96 | $1,737.80 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $645.65 / $1,122.02 / $5,754.40
| Facility | | $645.65 | $1,122.02 | $5,754.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $724.44 / $977.24 / $1,819.70
| Professional | | $724.44 | $977.24 | $1,819.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $707.95 / $812.83 / $1,479.11
| Professional | | $707.95 | $812.83 | $1,479.11 |