- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,238.72 / $4,073.80 / $11,481.54
| Facility | | $2,238.72 | $4,073.80 | $11,481.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,659.59 / $2,137.96 / $6,606.93
| Professional | | $1,659.59 | $2,137.96 | $6,606.93 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,677.35 / $9,772.37 / $18,620.87
| Facility | | $4,677.35 | $9,772.37 | $18,620.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,380.38 / $1,778.28 / $5,128.61
| Professional | | $1,380.38 | $1,778.28 | $5,128.61 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,884.03 / $2,884.03 / $37,153.52
| Facility | | $2,884.03 | $2,884.03 | $37,153.52 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,884.03 / $2,884.03 / $2,884.03
| Professional | | $2,884.03 | $2,884.03 | $2,884.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $34.67 / $5,754.40 / $53,703.18
| Facility | | $34.67 | $5,754.40 | $53,703.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,380.38 / $3,715.35 / $9,332.54
| Professional | | $1,380.38 | $3,715.35 | $9,332.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,089.30 / $4,073.80 / $6,918.31
| Facility | | $2,089.30 | $4,073.80 | $6,918.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,862.09 / $2,570.40 / $3,630.78
| Professional | | $1,862.09 | $2,570.40 | $3,630.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,659.59 / $2,630.27 / $4,265.80
| Professional | | $1,659.59 | $2,630.27 | $4,265.80 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,089.30 / $50,118.72 / $75,857.76
| Facility | | $2,089.30 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $398.11 / $2,754.23 / $6,025.60
| Professional | | $398.11 | $2,754.23 | $6,025.60 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,344.23 / $5,495.41 / $19,054.61
| Facility | | $2,344.23 | $5,495.41 | $19,054.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,348.96 / $2,754.23 / $6,456.54
| Professional | | $1,348.96 | $2,754.23 | $6,456.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,621.81 / $2,137.96 / $7,079.46
| Facility | | $1,621.81 | $2,137.96 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,621.81 / $2,454.71 / $6,309.57
| Professional | | $1,621.81 | $2,454.71 | $6,309.57 |