- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,548.13 / $8,912.51 / $22,387.21
| Facility | | $3,548.13 | $8,912.51 | $22,387.21 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,445.44 / $2,137.96 / $3,162.28
| Professional | | $1,445.44 | $2,137.96 | $3,162.28 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,570.88 / $8,128.31 / $15,848.93
| Facility | | $4,570.88 | $8,128.31 | $15,848.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $251.19 / $3,235.94 / $5,623.41
| Professional | | $251.19 | $3,235.94 | $5,623.41 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $77.62 / $1,380.38 / $3,388.44
| Facility | | $77.62 | $1,380.38 | $3,388.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $208.93 / $1,737.80 / $4,466.84
| Professional | | $208.93 | $1,737.80 | $4,466.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $588.84 / $741.31 / $2,290.87
| Professional | | $588.84 | $741.31 | $2,290.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,235.94 / $3,235.94 / $3,388.44
| Professional | | $3,235.94 | $3,235.94 | $3,388.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $208.93 / $467.74 / $3,715.35
| Professional | | $208.93 | $467.74 | $3,715.35 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13,182.57 / $13,182.57 / $13,182.57
| Facility | | $13,182.57 | $13,182.57 | $13,182.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12,589.25 / $14,454.40 / $14,454.40
| Professional | | $12,589.25 | $14,454.40 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $245.47 / $2,454.71 / $3,630.78
| Facility | | $245.47 | $2,454.71 | $3,630.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $199.53 / $208.93 / $3,801.89
| Professional | | $199.53 | $208.93 | $3,801.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,981.07 / $7,413.10 / $15,135.61
| Facility | | $3,981.07 | $7,413.10 | $15,135.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,089.30 / $2,951.21 / $6,760.83
| Professional | | $2,089.30 | $2,951.21 | $6,760.83 |