- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,890.45 / $8,128.31 / $20,892.96
| Facility | | $3,890.45 | $8,128.31 | $20,892.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,778.28 / $2,454.71 / $5,128.61
| Professional | | $1,778.28 | $2,454.71 | $5,128.61 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11,481.54 / $14,791.08 / $28,840.32
| Facility | | $11,481.54 | $14,791.08 | $28,840.32 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,884.03 / $4,073.80 / $5,754.40
| Professional | | $2,884.03 | $4,073.80 | $5,754.40 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $758.58 / $758.58 / $870.96
| Facility | | $758.58 | $758.58 | $870.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,995.26 / $3,467.37 / $6,309.57
| Professional | | $1,995.26 | $3,467.37 | $6,309.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,238.72 / $4,265.80 / $9,120.11
| Facility | | $2,238.72 | $4,265.80 | $9,120.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,089.30 / $4,073.80 / $6,918.31
| Professional | | $2,089.30 | $4,073.80 | $6,918.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $134.90
| Professional | | $32.36 | $33.11 | $134.90 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,630.27 / $3,890.45 / $4,168.69
| Facility | | $2,630.27 | $3,890.45 | $4,168.69 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,818.38 / $2,818.38 / $2,884.03
| Facility | | $2,818.38 | $2,818.38 | $2,884.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,884.03 / $4,265.80 / $5,495.41
| Professional | | $2,884.03 | $4,265.80 | $5,495.41 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10,471.29 / $14,791.08 / $28,840.32
| Facility | | $10,471.29 | $14,791.08 | $28,840.32 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,884.03 / $4,073.80 / $5,623.41
| Professional | | $2,884.03 | $4,073.80 | $5,623.41 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,467.37 / $17,378.01 / $33,884.42
| Facility | | $3,467.37 | $17,378.01 | $33,884.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,137.96 / $3,019.95 / $5,495.41
| Professional | | $2,137.96 | $3,019.95 | $5,495.41 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,995.26 / $2,137.96 / $3,801.89
| Professional | | $1,995.26 | $2,137.96 | $3,801.89 |