- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,365.16 / $10,232.93 / $21,379.62
| Facility | | $4,365.16 | $10,232.93 | $21,379.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,412.54 / $2,137.96 / $8,128.31
| Professional | | $1,412.54 | $2,137.96 | $8,128.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11,220.18 / $16,982.44 / $28,840.32
| Facility | | $11,220.18 | $16,982.44 | $28,840.32 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,778.28 / $2,454.71 / $5,370.32
| Professional | | $1,778.28 | $2,454.71 | $5,370.32 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $81.28 / $8,912.51 / $17,378.01
| Facility | | $81.28 | $8,912.51 | $17,378.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,380.38 / $2,041.74 / $4,677.35
| Professional | | $1,380.38 | $2,041.74 | $4,677.35 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,659.59 / $2,398.83 / $5,011.87
| Professional | | $1,659.59 | $2,398.83 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,230.27 / $2,137.96 / $2,951.21
| Professional | | $1,230.27 | $2,137.96 | $2,951.21 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,778.28 / $2,398.83 / $4,570.88
| Professional | | $1,778.28 | $2,398.83 | $4,570.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $54.95 / $56.23 / $77,624.71
| Facility | | $54.95 | $56.23 | $77,624.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14,125.38 / $18,197.01 / $18,197.01
| Professional | | $14,125.38 | $18,197.01 | $18,197.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,019.95 / $3,019.95 / $3,019.95
| Professional | | $3,019.95 | $3,019.95 | $3,019.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,862.09 / $2,454.71 / $4,073.80
| Facility | | $1,862.09 | $2,454.71 | $4,073.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,659.59 / $2,398.83 / $5,128.61
| Professional | | $1,659.59 | $2,398.83 | $5,128.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6,309.57 / $6,309.57 / $6,309.57
| Professional | | $6,309.57 | $6,309.57 | $6,309.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,230.27 / $1,819.70 / $2,187.76
| Professional | | $1,230.27 | $1,819.70 | $2,187.76 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9,549.93 / $17,378.01 / $38,018.94
| Facility | | $9,549.93 | $17,378.01 | $38,018.94 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,513.56 / $1,995.26 / $4,570.88
| Professional | | $1,513.56 | $1,995.26 | $4,570.88 |