- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,786.30 / $8,511.38 / $14,454.40
| Facility | | $4,786.30 | $8,511.38 | $14,454.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,584.89 / $2,398.83 / $9,332.54
| Professional | | $1,584.89 | $2,398.83 | $9,332.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,548.13 / $3,548.13 / $3,548.13
| Professional | | $3,548.13 | $3,548.13 | $3,548.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7,762.47 / $10,232.93 / $19,952.62
| Facility | | $7,762.47 | $10,232.93 | $19,952.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,513.56 / $2,570.40 / $3,467.37
| Professional | | $1,513.56 | $2,570.40 | $3,467.37 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $19,054.61 / $19,054.61 / $19,054.61
| Facility | | $19,054.61 | $19,054.61 | $19,054.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,905.46 / $3,890.45 / $4,897.79
| Professional | | $1,905.46 | $3,890.45 | $4,897.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,584.89 / $2,818.38 / $14,791.08
| Facility | | $1,584.89 | $2,818.38 | $14,791.08 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,862.09 / $3,235.94 / $13,489.63
| Professional | | $1,862.09 | $3,235.94 | $13,489.63 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,311.31 / $3,981.07 / $5,495.41
| Professional | | $3,311.31 | $3,981.07 | $5,495.41 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $19,054.61 / $19,054.61 / $19,054.61
| Facility | | $19,054.61 | $19,054.61 | $19,054.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,311.31 / $3,801.89 / $5,495.41
| Professional | | $3,311.31 | $3,801.89 | $5,495.41 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8,709.64 / $16,218.10 / $26,302.68
| Facility | | $8,709.64 | $16,218.10 | $26,302.68 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,995.26 / $3,162.28 / $4,365.16
| Professional | | $1,995.26 | $3,162.28 | $4,365.16 |