- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,981.07 / $9,772.37 / $20,892.96
| Facility | | $3,981.07 | $9,772.37 | $20,892.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $537.03 / $707.95 / $2,630.27
| Professional | | $537.03 | $707.95 | $2,630.27 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,456.54 / $11,481.54 / $18,620.87
| Facility | | $6,456.54 | $11,481.54 | $18,620.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $707.95 / $954.99 / $1,905.46
| Professional | | $707.95 | $954.99 | $1,905.46 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $85.11 / $8,317.64 / $16,982.44
| Facility | | $85.11 | $8,317.64 | $16,982.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $660.69 / $954.99 / $1,862.09
| Professional | | $660.69 | $954.99 | $1,862.09 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $18,197.01 / $18,197.01 / $18,197.01
| Facility | | $18,197.01 | $18,197.01 | $18,197.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $616.60 / $812.83 / $1,698.24
| Professional | | $616.60 | $812.83 | $1,698.24 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $537.03 / $707.95 / $954.99
| Professional | | $537.03 | $707.95 | $954.99 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $575.44 / $758.58 / $1,479.11
| Professional | | $575.44 | $758.58 | $1,479.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $42,657.95 / $42,657.95 / $56,234.13
| Facility | | $42,657.95 | $42,657.95 | $56,234.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4,677.35 / $5,623.41 / $5,623.41
| Professional | | $4,677.35 | $5,623.41 | $5,623.41 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $933.25 / $933.25 / $933.25
| Professional | | $933.25 | $933.25 | $933.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $54.95 / $54.95 / $70.79
| Professional | | $54.95 | $54.95 | $70.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $630.96 / $831.76 / $1,288.25
| Facility | | $630.96 | $831.76 | $1,288.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $616.60 / $812.83 / $1,698.24
| Professional | | $616.60 | $812.83 | $1,698.24 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,089.30 / $2,089.30 / $2,089.30
| Professional | | $2,089.30 | $2,089.30 | $2,089.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $575.44 / $794.33 / $1,148.15
| Professional | | $575.44 | $794.33 | $1,148.15 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,760.83 / $12,022.64 / $26,302.68
| Facility | | $6,760.83 | $12,022.64 | $26,302.68 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $501.19 / $676.08 / $1,479.11
| Professional | | $501.19 | $676.08 | $1,479.11 |