- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,698.24 / $5,495.41 / $10,964.78
| Facility | | $1,698.24 | $5,495.41 | $10,964.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,513.56 / $1,698.24 / $3,311.31
| Professional | | $1,513.56 | $1,698.24 | $3,311.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,606.93 / $7,413.10 / $9,332.54
| Facility | | $6,606.93 | $7,413.10 | $9,332.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,584.89 / $2,344.23 / $4,073.80
| Professional | | $1,584.89 | $2,344.23 | $4,073.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,778.28 / $2,344.23 / $6,760.83
| Professional | | $1,778.28 | $2,344.23 | $6,760.83 |
- 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
- $1,548.82 / $2,089.30 / $3,467.37
| Professional | | $1,548.82 | $2,089.30 | $3,467.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,380.38 / $1,698.24 / $2,041.74
| Professional | | $1,380.38 | $1,698.24 | $2,041.74 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,238.72 / $2,818.38 / $3,890.45
| Professional | | $2,238.72 | $2,818.38 | $3,890.45 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,548.82 / $2,137.96 / $3,235.94
| Facility | | $1,548.82 | $2,137.96 | $3,235.94 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,137.96 / $2,137.96 / $2,137.96
| Professional | | $2,137.96 | $2,137.96 | $2,137.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,548.82 / $2,187.76 / $9,549.93
| Facility | | $1,548.82 | $2,187.76 | $9,549.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,548.82 / $2,187.76 / $9,549.93
| Professional | | $1,548.82 | $2,187.76 | $9,549.93 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,456.54 / $10,471.29 / $21,379.62
| Facility | | $6,456.54 | $10,471.29 | $21,379.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,258.93 / $1,995.26 / $3,162.28
| Professional | | $1,258.93 | $1,995.26 | $3,162.28 |