- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,096.48 / $4,073.80 / $8,317.64
| Facility | | $1,096.48 | $4,073.80 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,202.26 / $1,659.59 / $6,606.93
| Professional | | $1,202.26 | $1,659.59 | $6,606.93 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,019.95 / $4,570.88 / $60,255.96
| Facility | | $3,019.95 | $4,570.88 | $60,255.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,584.89 / $1,584.89 / $1,995.26
| Professional | | $1,584.89 | $1,584.89 | $1,995.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,011.87 / $6,165.95 / $57,543.99
| Facility | | $5,011.87 | $6,165.95 | $57,543.99 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,174.90 / $1,584.89 / $2,691.53
| Professional | | $1,174.90 | $1,584.89 | $2,691.53 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,445.44 / $2,187.76 / $2,398.83
| Professional | | $1,445.44 | $2,187.76 | $2,398.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,258.93 / $1,778.28 / $2,454.71
| Professional | | $1,258.93 | $1,778.28 | $2,454.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,495.41 / $8,317.64 / $12,882.50
| Facility | | $5,495.41 | $8,317.64 | $12,882.50 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,754.23 / $3,715.35 / $16,595.87
| Facility | | $2,754.23 | $3,715.35 | $16,595.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,584.89 / $1,584.89 / $1,995.26
| Professional | | $1,584.89 | $1,584.89 | $1,995.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $954.99 / $3,630.78 / $7,244.36
| Facility | | $954.99 | $3,630.78 | $7,244.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,202.26 / $1,513.56 / $3,019.95
| Professional | | $1,202.26 | $1,513.56 | $3,019.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,548.82 / $2,570.40 / $5,888.44
| Professional | | $1,548.82 | $2,570.40 | $5,888.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $467.74 / $1,380.38 / $1,548.82
| Facility | | $467.74 | $1,380.38 | $1,548.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $467.74 / $1,380.38 / $1,548.82
| Professional | | $467.74 | $1,380.38 | $1,548.82 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,137.96 / $4,897.79 / $11,481.54
| Facility | | $2,137.96 | $4,897.79 | $11,481.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,174.90 / $1,584.89 / $2,884.03
| Professional | | $1,174.90 | $1,584.89 | $2,884.03 |