- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $954.99 / $7,943.28 / $13,489.63
| Facility | | $954.99 | $7,943.28 | $13,489.63 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $457.09 / $2,511.89 / $14,125.38
| Professional | | $457.09 | $2,511.89 | $14,125.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7,079.46 / $7,079.46 / $7,079.46
| Professional | | $7,079.46 | $7,079.46 | $7,079.46 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,606.93 / $8,709.64 / $16,982.44
| Facility | | $6,606.93 | $8,709.64 | $16,982.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $524.81 / $4,570.88 / $10,471.29
| Professional | | $524.81 | $4,570.88 | $10,471.29 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,495.41 / $5,495.41 / $5,495.41
| Facility | | $5,495.41 | $5,495.41 | $5,495.41 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $891.25 / $7,079.46 / $15,488.17
| Professional | | $891.25 | $7,079.46 | $15,488.17 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $537.03 / $6,165.95 / $11,220.18
| Facility | | $537.03 | $6,165.95 | $11,220.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7,244.36 / $13,182.57 / $20,892.96
| Professional | | $7,244.36 | $13,182.57 | $20,892.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,047.13 / $10,232.93 / $18,197.01
| Professional | | $1,047.13 | $10,232.93 | $18,197.01 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,495.41 / $5,495.41 / $5,495.41
| Facility | | $5,495.41 | $5,495.41 | $5,495.41 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $891.25 / $1,621.81 / $18,197.01
| Professional | | $891.25 | $1,621.81 | $18,197.01 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,918.31 / $8,511.38 / $10,964.78
| Facility | | $6,918.31 | $8,511.38 | $10,964.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $588.84 / $6,760.83 / $15,848.93
| Professional | | $588.84 | $6,760.83 | $15,848.93 |