- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,370.32 / $9,549.93 / $18,197.01
| Facility | | $5,370.32 | $9,549.93 | $18,197.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,479.11 / $2,290.87 / $8,709.64
| Professional | | $1,479.11 | $2,290.87 | $8,709.64 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,456.54 / $8,511.38 / $16,595.87
| Facility | | $6,456.54 | $8,511.38 | $16,595.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,445.44 / $2,454.71 / $3,467.37
| Professional | | $1,445.44 | $2,454.71 | $3,467.37 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7,585.78 / $7,585.78 / $7,585.78
| Facility | | $7,585.78 | $7,585.78 | $7,585.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,737.80 / $3,630.78 / $4,570.88
| Professional | | $1,737.80 | $3,630.78 | $4,570.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,479.11 / $2,630.27 / $9,772.37
| Facility | | $1,479.11 | $2,630.27 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,698.24 / $2,951.21 / $23,988.33
| Professional | | $1,698.24 | $2,951.21 | $23,988.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,019.95 / $3,715.35 / $5,011.87
| Professional | | $3,019.95 | $3,715.35 | $5,011.87 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7,585.78 / $7,585.78 / $7,585.78
| Facility | | $7,585.78 | $7,585.78 | $7,585.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,019.95 / $3,467.37 / $5,011.87
| Professional | | $3,019.95 | $3,467.37 | $5,011.87 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,309.57 / $7,413.10 / $9,120.11
| Facility | | $6,309.57 | $7,413.10 | $9,120.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,819.70 / $2,884.03 / $3,981.07
| Professional | | $1,819.70 | $2,884.03 | $3,981.07 |