- 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
- $2,187.76 / $2,754.23 / $6,456.54
| Professional | | $2,187.76 | $2,754.23 | $6,456.54 |
- 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
- $2,041.74 / $2,570.40 / $5,888.44
| Professional | | $2,041.74 | $2,570.40 | $5,888.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,467.37 / $3,467.37 / $37,153.52
| Facility | | $3,467.37 | $3,467.37 | $37,153.52 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,467.37 / $3,467.37 / $3,467.37
| Professional | | $3,467.37 | $3,467.37 | $3,467.37 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $34.67 / $4,168.69 / $50,118.72
| Facility | | $34.67 | $4,168.69 | $50,118.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,398.83 / $3,981.07 / $11,220.18
| Professional | | $2,398.83 | $3,981.07 | $11,220.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,570.40 / $3,715.35 / $8,317.64
| Facility | | $2,570.40 | $3,715.35 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,454.71 / $3,630.78 / $5,370.32
| Professional | | $2,454.71 | $3,630.78 | $5,370.32 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,290.87 / $2,290.87 / $2,290.87
| Facility | | $2,290.87 | $2,290.87 | $2,290.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,819.70 / $3,235.94 / $5,128.61
| Professional | | $1,819.70 | $3,235.94 | $5,128.61 |
- 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 / $3,311.31 / $5,495.41
| Professional | | $398.11 | $3,311.31 | $5,495.41 |
- 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
- $2,187.76 / $3,388.44 / $10,471.29
| Professional | | $2,187.76 | $3,388.44 | $10,471.29 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,995.26 / $2,951.21 / $11,481.54
| Facility | | $1,995.26 | $2,951.21 | $11,481.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,819.70 / $3,019.95 / $7,413.10
| Professional | | $1,819.70 | $3,019.95 | $7,413.10 |