- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,905.46 / $12,589.25 / $28,183.83
| Facility | | $1,905.46 | $12,589.25 | $28,183.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $912.01 / $1,202.26 / $2,570.40
| Professional | | $912.01 | $1,202.26 | $2,570.40 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10,715.19 / $15,488.17 / $31,622.78
| Facility | | $10,715.19 | $15,488.17 | $31,622.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,380.38 / $1,995.26 / $2,818.38
| Professional | | $1,380.38 | $1,995.26 | $2,818.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $707.95 / $870.96 / $8,317.64
| Facility | | $707.95 | $870.96 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,000.00 / $1,698.24 / $3,019.95
| Professional | | $1,000.00 | $1,698.24 | $3,019.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,071.52 / $2,089.30 / $7,079.46
| Facility | | $1,071.52 | $2,089.30 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,047.13 / $2,041.74 / $5,370.32
| Professional | | $1,047.13 | $2,041.74 | $5,370.32 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $123.03
| Professional | | $32.36 | $33.11 | $123.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,659.59 / $1,995.26 / $2,041.74
| Facility | | $1,659.59 | $1,995.26 | $2,041.74 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,348.96 / $1,380.38 / $2,290.87
| Facility | | $1,348.96 | $1,380.38 | $2,290.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,380.38 / $2,041.74 / $2,630.27
| Professional | | $1,380.38 | $2,041.74 | $2,630.27 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10,715.19 / $16,218.10 / $31,622.78
| Facility | | $10,715.19 | $16,218.10 | $31,622.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,380.38 / $1,949.84 / $2,754.23
| Professional | | $1,380.38 | $1,949.84 | $2,754.23 |
- 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
- $1,071.52 / $1,479.11 / $2,630.27
| Professional | | $1,071.52 | $1,479.11 | $2,630.27 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $977.24 / $1,047.13 / $1,862.09
| Professional | | $977.24 | $1,047.13 | $1,862.09 |