- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,174.90 / $3,981.07 / $14,454.40
| Facility | | $1,174.90 | $3,981.07 | $14,454.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,995.26 / $2,290.87 / $3,890.45
| Professional | | $1,995.26 | $2,290.87 | $3,890.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,995.26 / $2,570.40 / $3,388.44
| Professional | | $1,995.26 | $2,570.40 | $3,388.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $79.43 / $1,905.46 / $1,995.26
| Facility | | $79.43 | $1,905.46 | $1,995.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,715.35 / $3,715.35 / $3,715.35
| Facility | | $3,715.35 | $3,715.35 | $3,715.35 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,089.30 / $2,951.21 / $4,677.35
| Professional | | $2,089.30 | $2,951.21 | $4,677.35 |
- 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
- $21,877.62 / $21,877.62 / $21,877.62
| Professional | | $21,877.62 | $21,877.62 | $21,877.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,819.70 / $2,951.21 / $5,754.40
| Facility | | $1,819.70 | $2,951.21 | $5,754.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,995.26 / $2,754.23 / $4,570.88
| Professional | | $1,995.26 | $2,754.23 | $4,570.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $281.84 / $1,862.09
| Professional | | $32.36 | $281.84 | $1,862.09 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,818.38 / $7,079.46 / $7,244.36
| Professional | | $2,818.38 | $7,079.46 | $7,244.36 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,041.74 / $2,818.38 / $4,897.79
| Facility | | $2,041.74 | $2,818.38 | $4,897.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,041.74 / $2,951.21 / $4,570.88
| Professional | | $2,041.74 | $2,951.21 | $4,570.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,786.30 / $11,220.18 / $21,379.62
| Facility | | $4,786.30 | $11,220.18 | $21,379.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,819.70 / $2,398.83 / $3,801.89
| Professional | | $1,819.70 | $2,398.83 | $3,801.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,905.46 / $1,949.84 / $2,041.74
| Professional | | $1,905.46 | $1,949.84 | $2,041.74 |