- 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
- $2,454.71 / $3,715.35 / $14,791.08
| Professional | | $2,454.71 | $3,715.35 | $14,791.08 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8,317.64 / $10,964.78 / $21,379.62
| Facility | | $8,317.64 | $10,964.78 | $21,379.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,398.83 / $4,073.80 / $5,370.32
| Professional | | $2,398.83 | $4,073.80 | $5,370.32 |
- 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
- $3,019.95 / $6,165.95 / $7,762.47
| Professional | | $3,019.95 | $6,165.95 | $7,762.47 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,454.71 / $4,365.16 / $9,772.37
| Facility | | $2,454.71 | $4,365.16 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,884.03 / $4,786.30 / $19,952.62
| Professional | | $2,884.03 | $4,786.30 | $19,952.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5,128.61 / $6,165.95 / $8,511.38
| Professional | | $5,128.61 | $6,165.95 | $8,511.38 |
- 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
- $5,128.61 / $5,888.44 / $8,511.38
| Professional | | $5,128.61 | $5,888.44 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,918.31 / $8,511.38 / $10,964.78
| Facility | | $6,918.31 | $8,511.38 | $10,964.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,090.30 / $4,786.30 / $6,760.83
| Professional | | $3,090.30 | $4,786.30 | $6,760.83 |