- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,454.71 / $4,677.35 / $10,964.78
| Facility | | $2,454.71 | $4,677.35 | $10,964.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,041.74 / $2,630.27 / $6,025.60
| Professional | | $2,041.74 | $2,630.27 | $6,025.60 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,073.80 / $7,762.47 / $13,803.84
| Facility | | $4,073.80 | $7,762.47 | $13,803.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,905.46 / $2,398.83 / $5,754.40
| Professional | | $1,905.46 | $2,398.83 | $5,754.40 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,235.94 / $3,235.94 / $37,153.52
| Facility | | $3,235.94 | $3,235.94 | $37,153.52 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,235.94 / $3,235.94 / $9,772.37
| Professional | | $3,235.94 | $3,235.94 | $9,772.37 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $34.67 / $3,890.45 / $50,118.72
| Facility | | $34.67 | $3,890.45 | $50,118.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,238.72 / $3,548.13 / $10,471.29
| Professional | | $2,238.72 | $3,548.13 | $10,471.29 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,398.83 / $3,548.13 / $7,762.47
| Facility | | $2,398.83 | $3,548.13 | $7,762.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,290.87 / $3,388.44 / $5,011.87
| Professional | | $2,290.87 | $3,388.44 | $5,011.87 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,137.96 / $2,137.96 / $2,137.96
| Facility | | $2,137.96 | $2,137.96 | $2,137.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,698.24 / $3,019.95 / $4,786.30
| Professional | | $1,698.24 | $3,019.95 | $4,786.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,786.30 / $50,118.72 / $75,857.76
| Facility | | $4,786.30 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $398.11 / $3,090.30 / $5,011.87
| Professional | | $398.11 | $3,090.30 | $5,011.87 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,398.83 / $5,495.41 / $12,589.25
| Facility | | $2,398.83 | $5,495.41 | $12,589.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,041.74 / $3,162.28 / $9,772.37
| Professional | | $2,041.74 | $3,162.28 | $9,772.37 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,862.09 / $2,754.23 / $10,715.19
| Facility | | $1,862.09 | $2,754.23 | $10,715.19 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,698.24 / $2,818.38 / $6,760.83
| Professional | | $1,698.24 | $2,818.38 | $6,760.83 |