- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,023.29 / $14,791.08 / $14,791.08
| Facility | | $1,023.29 | $14,791.08 | $14,791.08 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $977.24 / $1,348.96 / $2,754.23
| Professional | | $977.24 | $1,348.96 | $2,754.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10,715.19 / $15,135.61 / $26,302.68
| Facility | | $10,715.19 | $15,135.61 | $26,302.68 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,023.29 / $2,137.96 / $5,495.41
| Professional | | $1,023.29 | $2,137.96 | $5,495.41 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,754.23 / $3,162.28 / $5,370.32
| Facility | | $2,754.23 | $3,162.28 | $5,370.32 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,318.26 / $4,265.80 / $4,897.79
| Professional | | $1,318.26 | $4,265.80 | $4,897.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,047.13 / $2,187.76 / $10,232.93
| Facility | | $1,047.13 | $2,187.76 | $10,232.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,862.09 / $2,511.89 / $3,235.94
| Professional | | $1,862.09 | $2,511.89 | $3,235.94 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,047.13 / $2,290.87 / $15,848.93
| Facility | | $1,047.13 | $2,290.87 | $15,848.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,122.02 / $2,041.74 / $7,943.28
| Professional | | $1,122.02 | $2,041.74 | $7,943.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $70.79
| Professional | | $32.36 | $33.11 | $70.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,089.30 / $9,332.54 / $15,848.93
| Facility | | $2,089.30 | $9,332.54 | $15,848.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,288.25 / $2,511.89 / $4,365.16
| Professional | | $1,288.25 | $2,511.89 | $4,365.16 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,548.82 / $2,344.23 / $3,388.44
| Professional | | $1,548.82 | $2,344.23 | $3,388.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13,489.63 / $19,952.62 / $19,952.62
| Facility | | $13,489.63 | $19,952.62 | $19,952.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,862.09 / $5,128.61 / $7,762.47
| Professional | | $1,862.09 | $5,128.61 | $7,762.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,388.44 / $3,388.44 / $3,388.44
| Professional | | $3,388.44 | $3,388.44 | $3,388.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,691.53 / $5,888.44 / $6,606.93
| Professional | | $2,691.53 | $5,888.44 | $6,606.93 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7,585.78 / $12,022.64 / $16,218.10
| Facility | | $7,585.78 | $12,022.64 | $16,218.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $89.13 / $3,090.30 / $6,606.93
| Professional | | $89.13 | $3,090.30 | $6,606.93 |