- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,011.87 / $7,943.28 / $14,454.40
| Facility | | $5,011.87 | $7,943.28 | $14,454.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,238.72 / $3,311.31 / $13,182.57
| Professional | | $2,238.72 | $3,311.31 | $13,182.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7,943.28 / $10,232.93 / $19,952.62
| Facility | | $7,943.28 | $10,232.93 | $19,952.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,137.96 / $3,630.78 / $4,897.79
| Professional | | $2,137.96 | $3,630.78 | $4,897.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7,079.46 / $7,079.46 / $7,079.46
| Facility | | $7,079.46 | $7,079.46 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,691.53 / $5,495.41 / $6,918.31
| Professional | | $2,691.53 | $5,495.41 | $6,918.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,238.72 / $3,981.07 / $8,912.51
| Facility | | $2,238.72 | $3,981.07 | $8,912.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,570.40 / $4,786.30 / $19,498.45
| Professional | | $2,570.40 | $4,786.30 | $19,498.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4,677.35 / $5,754.40 / $7,585.78
| Professional | | $4,677.35 | $5,754.40 | $7,585.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7,079.46 / $7,079.46 / $7,079.46
| Facility | | $7,079.46 | $7,079.46 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4,677.35 / $5,248.07 / $7,585.78
| Professional | | $4,677.35 | $5,248.07 | $7,585.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,309.57 / $7,585.78 / $10,964.78
| Facility | | $6,309.57 | $7,585.78 | $10,964.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,818.38 / $4,365.16 / $6,456.54
| Professional | | $2,818.38 | $4,365.16 | $6,456.54 |