- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $954.99 / $12,589.25 / $20,417.38
| Facility | | $954.99 | $12,589.25 | $20,417.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $457.09 / $4,786.30 / $12,302.69
| Professional | | $457.09 | $4,786.30 | $12,302.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $912.01 / $912.01 / $912.01
| Professional | | $912.01 | $912.01 | $912.01 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13,803.84 / $19,054.61 / $38,904.51
| Facility | | $13,803.84 | $19,054.61 | $38,904.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $724.44 / $3,467.37 / $14,125.38
| Professional | | $724.44 | $3,467.37 | $14,125.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $707.95 / $758.58 / $8,317.64
| Facility | | $707.95 | $758.58 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $562.34 / $1,479.11 / $15,848.93
| Professional | | $562.34 | $1,479.11 | $15,848.93 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $549.54 / $6,456.54 / $15,848.93
| Facility | | $549.54 | $6,456.54 | $15,848.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $549.54 / $6,309.57 / $14,791.08
| Professional | | $549.54 | $6,309.57 | $14,791.08 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $33.11
| Professional | | $32.36 | $33.11 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8,709.64 / $10,471.29 / $13,489.63
| Facility | | $8,709.64 | $10,471.29 | $13,489.63 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,456.54 / $7,585.78 / $8,128.31
| Facility | | $6,456.54 | $7,585.78 | $8,128.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $645.65 / $7,585.78 / $13,803.84
| Professional | | $645.65 | $7,585.78 | $13,803.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14,454.40 / $19,952.62 / $38,904.51
| Facility | | $14,454.40 | $19,952.62 | $38,904.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $724.44 / $3,467.37 / $14,125.38
| Professional | | $724.44 | $3,467.37 | $14,125.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,128.61 / $20,892.96 / $41,686.94
| Facility | | $5,128.61 | $20,892.96 | $41,686.94 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $616.60 / $5,754.40 / $14,454.40
| Professional | | $616.60 | $5,754.40 | $14,454.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $457.09 / $870.96 / $8,511.38
| Professional | | $457.09 | $870.96 | $8,511.38 |