- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,467.37 / $7,943.28 / $22,908.68
| Facility | | $3,467.37 | $7,943.28 | $22,908.68 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,621.81 / $2,290.87 / $4,466.84
| Professional | | $1,621.81 | $2,290.87 | $4,466.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $28,183.83 / $35,481.34 / $70,794.58
| Facility | | $28,183.83 | $35,481.34 | $70,794.58 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,511.89 / $3,548.13 / $5,011.87
| Professional | | $2,511.89 | $3,548.13 | $5,011.87 |
- 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
- $1,778.28 / $2,951.21 / $5,370.32
| Professional | | $1,778.28 | $2,951.21 | $5,370.32 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,905.46 / $3,715.35 / $22,387.21
| Facility | | $1,905.46 | $3,715.35 | $22,387.21 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,778.28 / $3,548.13 / $16,982.44
| Professional | | $1,778.28 | $3,548.13 | $16,982.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $117.49
| Professional | | $32.36 | $33.11 | $117.49 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,238.72 / $3,467.37 / $3,630.78
| Facility | | $2,238.72 | $3,467.37 | $3,630.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,454.71 / $2,454.71 / $2,570.40
| Facility | | $2,454.71 | $2,454.71 | $2,570.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,570.40 / $3,715.35 / $4,897.79
| Professional | | $2,570.40 | $3,715.35 | $4,897.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $25,703.96 / $35,481.34 / $70,794.58
| Facility | | $25,703.96 | $35,481.34 | $70,794.58 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,511.89 / $3,548.13 / $5,011.87
| Professional | | $2,511.89 | $3,548.13 | $5,011.87 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,288.25 / $35,481.34 / $72,443.60
| Facility | | $1,288.25 | $35,481.34 | $72,443.60 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,862.09 / $2,630.27 / $4,786.30
| Professional | | $1,862.09 | $2,630.27 | $4,786.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,949.84 / $2,041.74 / $3,630.78
| Professional | | $1,949.84 | $2,041.74 | $3,630.78 |