- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,677.35 / $17,782.79 / $28,183.83
| Facility | | $4,677.35 | $17,782.79 | $28,183.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $851.14 / $1,202.26 / $1,548.82
| Professional | | $851.14 | $1,202.26 | $1,548.82 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10,715.19 / $15,135.61 / $30,902.95
| Facility | | $10,715.19 | $15,135.61 | $30,902.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,513.56 / $2,238.72 / $3,019.95
| Professional | | $1,513.56 | $2,238.72 | $3,019.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8,912.51 / $8,912.51 / $8,912.51
| Facility | | $8,912.51 | $8,912.51 | $8,912.51 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,011.87 / $9,332.54 / $23,988.33
| Facility | | $5,011.87 | $9,332.54 | $23,988.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4,897.79 / $7,585.78 / $10,964.78
| Professional | | $4,897.79 | $7,585.78 | $10,964.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $44.67 / $50.12 / $64.57
| Professional | | $44.67 | $50.12 | $64.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,174.90 / $1,174.90 / $4,677.35
| Facility | | $1,174.90 | $1,174.90 | $4,677.35 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,513.56 / $1,819.70 / $1,819.70
| Facility | | $1,513.56 | $1,819.70 | $1,819.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,513.56 / $2,238.72 / $3,467.37
| Professional | | $1,513.56 | $2,238.72 | $3,467.37 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10,471.29 / $15,848.93 / $30,902.95
| Facility | | $10,471.29 | $15,848.93 | $30,902.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,513.56 / $2,290.87 / $3,019.95
| Professional | | $1,513.56 | $2,290.87 | $3,019.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,467.37 / $17,782.79 / $32,359.37
| Facility | | $3,467.37 | $17,782.79 | $32,359.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,380.38 / $2,137.96 / $3,235.94
| Professional | | $1,380.38 | $2,137.96 | $3,235.94 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $257.04 / $489.78 / $1,862.09
| Professional | | $257.04 | $489.78 | $1,862.09 |