- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,995.26 / $5,754.40 / $16,982.44
| Facility | | $1,995.26 | $5,754.40 | $16,982.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,258.93 / $2,137.96 / $4,786.30
| Professional | | $1,258.93 | $2,137.96 | $4,786.30 |
- Facility/Professional
- Professional
- Modifier
- AS
- Typical Low / Median / Typical High
- $181.97 / $331.13 / $1,071.52
| Professional | AS | $181.97 | $331.13 | $1,071.52 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $169.82 / $1,258.93 / $1,412.54
| Professional | | $169.82 | $1,258.93 | $1,412.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,238.72 / $9,549.93 / $21,379.62
| Facility | | $2,238.72 | $9,549.93 | $21,379.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,445.44 / $1,778.28 / $2,818.38
| Professional | | $1,445.44 | $1,778.28 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- AS
- Typical Low / Median / Typical High
- $199.53 / $245.47 / $389.05
| Professional | AS | $199.53 | $245.47 | $389.05 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,348.96 / $1,584.89 / $2,137.96
| Professional | | $1,348.96 | $1,584.89 | $2,137.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,456.54 / $10,964.78 / $11,481.54
| Facility | | $6,456.54 | $10,964.78 | $11,481.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,202.26 / $1,905.46 / $3,162.28
| Professional | | $1,202.26 | $1,905.46 | $3,162.28 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,047.13 / $2,187.76 / $15,488.17
| Facility | | $1,047.13 | $2,187.76 | $15,488.17 |
- Facility/Professional
- Facility
- Modifier
- AS
- Typical Low / Median / Typical High
- $363.08 / $7,762.47 / $7,762.47
| Facility | AS | $363.08 | $7,762.47 | $7,762.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,380.38 / $2,089.30 / $10,715.19
| Professional | | $1,380.38 | $2,089.30 | $10,715.19 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,162.28 / $5,248.07 / $19,498.45
| Facility | | $3,162.28 | $5,248.07 | $19,498.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,288.25 / $1,737.80 / $2,754.23
| Professional | | $1,288.25 | $1,737.80 | $2,754.23 |