- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,235.94 / $4,786.30 / $9,549.93
| Facility | | $3,235.94 | $4,786.30 | $9,549.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,548.13 / $4,073.80 / $7,244.36
| Professional | | $3,548.13 | $4,073.80 | $7,244.36 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9,772.37 / $13,182.57 / $15,488.17
| Facility | | $9,772.37 | $13,182.57 | $15,488.17 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,801.89 / $5,623.41 / $9,549.93
| Professional | | $3,801.89 | $5,623.41 | $9,549.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4,168.69 / $6,025.60 / $21,379.62
| Professional | | $4,168.69 | $6,025.60 | $21,379.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $645.65 / $645.65 / $645.65
| Facility | | $645.65 | $645.65 | $645.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,715.35 / $5,128.61 / $8,317.64
| Professional | | $3,715.35 | $5,128.61 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,311.31 / $4,168.69 / $5,011.87
| Professional | | $3,311.31 | $4,168.69 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5,623.41 / $7,079.46 / $9,120.11
| Professional | | $5,623.41 | $7,079.46 | $9,120.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,801.89 / $5,011.87 / $7,762.47
| Facility | | $3,801.89 | $5,011.87 | $7,762.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6,025.60 / $6,025.60 / $6,025.60
| Professional | | $6,025.60 | $6,025.60 | $6,025.60 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,715.35 / $5,248.07 / $12,589.25
| Facility | | $3,715.35 | $5,248.07 | $12,589.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,715.35 / $5,248.07 / $12,589.25
| Professional | | $3,715.35 | $5,248.07 | $12,589.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10,471.29 / $17,782.79 / $33,884.42
| Facility | | $10,471.29 | $17,782.79 | $33,884.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,090.30 / $4,786.30 / $7,585.78
| Professional | | $3,090.30 | $4,786.30 | $7,585.78 |