- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,454.71 / $5,495.41 / $8,709.64
| Facility | | $2,454.71 | $5,495.41 | $8,709.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,584.89 / $2,290.87 / $3,388.44
| Professional | | $1,584.89 | $2,290.87 | $3,388.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $208.93 / $208.93 / $4,265.80
| Professional | | $208.93 | $208.93 | $4,265.80 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,818.38 / $3,801.89 / $10,964.78
| Facility | | $2,818.38 | $3,801.89 | $10,964.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,951.21 / $14,125.38 / $14,125.38
| Professional | | $2,951.21 | $14,125.38 | $14,125.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,951.21 / $4,786.30 / $11,220.18
| Facility | | $2,951.21 | $4,786.30 | $11,220.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,951.21 / $3,801.89 / $5,623.41
| Professional | | $2,951.21 | $3,801.89 | $5,623.41 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,290.87 / $2,754.23 / $5,248.07
| Professional | | $2,290.87 | $2,754.23 | $5,248.07 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,801.89 / $5,495.41 / $50,118.72
| Facility | | $3,801.89 | $5,495.41 | $50,118.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,951.21 / $2,951.21 / $3,019.95
| Professional | | $2,951.21 | $2,951.21 | $3,019.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,630.27 / $2,951.21 / $3,630.78
| Facility | | $2,630.27 | $2,951.21 | $3,630.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,230.27 / $1,737.80 / $3,981.07
| Professional | | $1,230.27 | $1,737.80 | $3,981.07 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,454.71 / $2,951.21 / $3,388.44
| Facility | | $2,454.71 | $2,951.21 | $3,388.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,995.26 / $2,951.21 / $6,918.31
| Professional | | $1,995.26 | $2,951.21 | $6,918.31 |