- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,677.35 / $15,848.93 / $28,183.83
| Facility | | $4,677.35 | $15,848.93 | $28,183.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,122.02 / $1,445.44 / $1,737.80
| Professional | | $1,122.02 | $1,445.44 | $1,737.80 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14,125.38 / $26,915.35 / $56,234.13
| Facility | | $14,125.38 | $26,915.35 | $56,234.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,089.30 / $2,818.38 / $3,801.89
| Professional | | $2,089.30 | $2,818.38 | $3,801.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10,471.29 / $10,471.29 / $17,378.01
| Facility | | $10,471.29 | $10,471.29 | $17,378.01 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9,120.11 / $24,547.09 / $42,657.95
| Facility | | $9,120.11 | $24,547.09 | $42,657.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4,786.30 / $4,786.30 / $4,786.30
| Professional | | $4,786.30 | $4,786.30 | $4,786.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $50.12 / $50.12 / $50.12
| Professional | | $50.12 | $50.12 | $50.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $933.25 / $1,096.48 / $10,232.93
| Facility | | $933.25 | $1,096.48 | $10,232.93 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,041.74 / $2,041.74 / $2,187.76
| Facility | | $2,041.74 | $2,041.74 | $2,187.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,187.76 / $3,235.94 / $4,365.16
| Professional | | $2,187.76 | $3,235.94 | $4,365.16 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $18,620.87 / $27,542.29 / $56,234.13
| Facility | | $18,620.87 | $27,542.29 | $56,234.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,089.30 / $2,754.23 / $3,801.89
| Professional | | $2,089.30 | $2,754.23 | $3,801.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,165.95 / $33,113.11 / $60,255.96
| Facility | | $6,165.95 | $33,113.11 | $60,255.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,621.81 / $2,454.71 / $4,265.80
| Professional | | $1,621.81 | $2,454.71 | $4,265.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,318.26 / $1,621.81 / $2,511.89
| Professional | | $1,318.26 | $1,621.81 | $2,511.89 |