- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,548.13 / $10,232.93 / $23,988.33
| Facility | | $3,548.13 | $10,232.93 | $23,988.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $467.74 / $676.08 / $2,884.03
| Professional | | $467.74 | $676.08 | $2,884.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,630.78 / $6,165.95 / $13,489.63
| Facility | | $3,630.78 | $6,165.95 | $13,489.63 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $501.19 / $758.58 / $1,584.89
| Professional | | $501.19 | $758.58 | $1,584.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $85.11 / $6,760.83 / $13,489.63
| Facility | | $85.11 | $6,760.83 | $13,489.63 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $537.03 / $812.83 / $1,737.80
| Professional | | $537.03 | $812.83 | $1,737.80 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,754.40 / $5,754.40 / $5,754.40
| Facility | | $5,754.40 | $5,754.40 | $5,754.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $524.81 / $758.58 / $1,445.44
| Professional | | $524.81 | $758.58 | $1,445.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $602.56 / $812.83 / $1,258.93
| Professional | | $602.56 | $812.83 | $1,258.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $512.86 / $794.33 / $1,412.54
| Professional | | $512.86 | $794.33 | $1,412.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16,982.44 / $33,884.42 / $33,884.42
| Facility | | $16,982.44 | $33,884.42 | $33,884.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4,897.79 / $5,623.41 / $5,623.41
| Professional | | $4,897.79 | $5,623.41 | $5,623.41 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $549.54 / $549.54 / $933.25
| Professional | | $549.54 | $549.54 | $933.25 |
- 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
- $537.03 / $794.33 / $1,258.93
| Facility | | $537.03 | $794.33 | $1,258.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $512.86 / $776.25 / $1,479.11
| Professional | | $512.86 | $776.25 | $1,479.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,737.80 / $1,737.80 / $2,238.72
| Professional | | $1,737.80 | $1,737.80 | $2,238.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $524.81 / $977.24 / $1,412.54
| Professional | | $524.81 | $977.24 | $1,412.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,981.07 / $7,585.78 / $15,135.61
| Facility | | $3,981.07 | $7,585.78 | $15,135.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $436.52 / $616.60 / $1,380.38
| Professional | | $436.52 | $616.60 | $1,380.38 |