- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,548.13 / $8,912.51 / $21,379.62
| Facility | | $3,548.13 | $8,912.51 | $21,379.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,344.23 / $2,884.03 / $9,549.93
| Professional | | $2,344.23 | $2,884.03 | $9,549.93 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,025.60 / $10,715.19 / $17,782.79
| Facility | | $6,025.60 | $10,715.19 | $17,782.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,951.21 / $3,981.07 / $7,943.28
| Professional | | $2,951.21 | $3,981.07 | $7,943.28 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $83.18 / $7,762.47 / $15,135.61
| Facility | | $83.18 | $7,762.47 | $15,135.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,570.40 / $3,630.78 / $7,413.10
| Professional | | $2,570.40 | $3,630.78 | $7,413.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,398.83 / $3,311.31 / $6,760.83
| Professional | | $2,398.83 | $3,311.31 | $6,760.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,949.84 / $2,754.23 / $3,715.35
| Professional | | $1,949.84 | $2,754.23 | $3,715.35 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,238.72 / $2,951.21 / $5,888.44
| Professional | | $2,238.72 | $2,951.21 | $5,888.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $54.95 / $56.23 / $26,302.68
| Facility | | $54.95 | $56.23 | $26,302.68 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19,498.45 / $23,442.29 / $23,442.29
| Professional | | $19,498.45 | $23,442.29 | $23,442.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,981.07 / $3,981.07 / $3,981.07
| Professional | | $3,981.07 | $3,981.07 | $3,981.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $54.95 / $54.95 / $70.79
| Professional | | $54.95 | $54.95 | $70.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,454.71 / $3,235.94 / $5,248.07
| Facility | | $2,454.71 | $3,235.94 | $5,248.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,398.83 / $3,311.31 / $6,918.31
| Professional | | $2,398.83 | $3,311.31 | $6,918.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8,912.51 / $8,912.51 / $8,912.51
| Professional | | $8,912.51 | $8,912.51 | $8,912.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,238.72 / $2,951.21 / $4,168.69
| Professional | | $2,238.72 | $2,951.21 | $4,168.69 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7,762.47 / $14,125.38 / $28,840.32
| Facility | | $7,762.47 | $14,125.38 | $28,840.32 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,089.30 / $2,818.38 / $6,165.95
| Professional | | $2,089.30 | $2,818.38 | $6,165.95 |