- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,715.35 / $9,549.93 / $22,908.68
| Facility | | $3,715.35 | $9,549.93 | $22,908.68 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $489.78 / $5,128.61 / $12,882.50
| Professional | | $489.78 | $5,128.61 | $12,882.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $549.54 / $549.54 / $549.54
| Professional | | $549.54 | $549.54 | $549.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,630.78 / $6,165.95 / $13,803.84
| Facility | | $3,630.78 | $6,165.95 | $13,803.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $676.08 / $1,412.54 / $19,054.61
| Professional | | $676.08 | $1,412.54 | $19,054.61 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $85.11 / $8,128.31 / $16,595.87
| Facility | | $85.11 | $8,128.31 | $16,595.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $537.03 / $4,365.16 / $15,488.17
| Professional | | $537.03 | $4,365.16 | $15,488.17 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,918.31 / $6,918.31 / $6,918.31
| Facility | | $6,918.31 | $6,918.31 | $6,918.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $562.34 / $1,737.80 / $13,182.57
| Professional | | $562.34 | $1,737.80 | $13,182.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $467.74 / $602.56 / $9,549.93
| Professional | | $467.74 | $602.56 | $9,549.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $457.09 / $4,897.79 / $11,481.54
| Professional | | $457.09 | $4,897.79 | $11,481.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $54.95 / $56.23 / $20,892.96
| Facility | | $54.95 | $56.23 | $20,892.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $52,480.75 / $52,480.75 / $52,480.75
| Professional | | $52,480.75 | $52,480.75 | $52,480.75 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4,570.88 / $4,570.88 / $7,585.78
| Professional | | $4,570.88 | $4,570.88 | $7,585.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $524.81 / $5,128.61 / $10,964.78
| Facility | | $524.81 | $5,128.61 | $10,964.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $562.34 / $1,445.44 / $13,803.84
| Professional | | $562.34 | $1,445.44 | $13,803.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,659.59 / $1,659.59 / $22,387.21
| Professional | | $1,659.59 | $1,659.59 | $22,387.21 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $457.09 / $660.69 / $7,413.10
| Professional | | $457.09 | $660.69 | $7,413.10 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7,762.47 / $12,882.50 / $28,840.32
| Facility | | $7,762.47 | $12,882.50 | $28,840.32 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $457.09 / $4,265.80 / $11,748.98
| Professional | | $457.09 | $4,265.80 | $11,748.98 |