- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,096.48 / $9,120.11 / $20,892.96
| Facility | | $1,096.48 | $9,120.11 | $20,892.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $512.86 / $741.31 / $1,479.11
| Professional | | $512.86 | $741.31 | $1,479.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13,803.84 / $19,054.61 / $38,904.51
| Facility | | $13,803.84 | $19,054.61 | $38,904.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $794.33 / $1,148.15 / $1,584.89
| Professional | | $794.33 | $1,148.15 | $1,584.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $707.95 / $758.58 / $8,317.64
| Facility | | $707.95 | $758.58 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $562.34 / $977.24 / $1,698.24
| Professional | | $562.34 | $977.24 | $1,698.24 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $616.60 / $1,202.26 / $10,964.78
| Facility | | $616.60 | $1,202.26 | $10,964.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $549.54 / $1,148.15 / $8,317.64
| Professional | | $549.54 | $1,148.15 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $263.03
| Professional | | $32.36 | $33.11 | $263.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $870.96 / $1,096.48 / $1,148.15
| Facility | | $870.96 | $1,096.48 | $1,148.15 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $776.25 / $812.83 / $2,187.76
| Facility | | $776.25 | $812.83 | $2,187.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $812.83 / $1,174.90 / $1,513.56
| Professional | | $812.83 | $1,174.90 | $1,513.56 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13,182.57 / $19,952.62 / $38,904.51
| Facility | | $13,182.57 | $19,952.62 | $38,904.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $794.33 / $1,148.15 / $1,584.89
| Professional | | $794.33 | $1,148.15 | $1,584.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,677.35 / $20,892.96 / $41,686.94
| Facility | | $4,677.35 | $20,892.96 | $41,686.94 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $588.84 / $812.83 / $1,513.56
| Professional | | $588.84 | $812.83 | $1,513.56 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $616.60 / $630.96 / $1,148.15
| Professional | | $616.60 | $630.96 | $1,148.15 |