- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,466.84 / $13,182.57 / $28,183.83
| Facility | | $4,466.84 | $13,182.57 | $28,183.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $954.99 / $1,071.52 / $2,187.76
| Professional | | $954.99 | $1,071.52 | $2,187.76 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $28,183.83 / $35,481.34 / $70,794.58
| Facility | | $28,183.83 | $35,481.34 | $70,794.58 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,479.11 / $2,137.96 / $2,951.21
| Professional | | $1,479.11 | $2,137.96 | $2,951.21 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $707.95 / $758.58 / $870.96
| Facility | | $707.95 | $758.58 | $870.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,047.13 / $1,819.70 / $3,235.94
| Professional | | $1,047.13 | $1,819.70 | $3,235.94 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,122.02 / $2,187.76 / $22,387.21
| Facility | | $1,122.02 | $2,187.76 | $22,387.21 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,047.13 / $2,089.30 / $16,982.44
| Professional | | $1,047.13 | $2,089.30 | $16,982.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $43.65 / $398.11 / $794.33
| Professional | | $43.65 | $398.11 | $794.33 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,288.25 / $2,137.96 / $2,137.96
| Facility | | $1,288.25 | $2,137.96 | $2,137.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,445.44 / $1,445.44 / $1,513.56
| Facility | | $1,445.44 | $1,445.44 | $1,513.56 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,513.56 / $2,187.76 / $2,884.03
| Professional | | $1,513.56 | $2,187.76 | $2,884.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $25,703.96 / $35,481.34 / $70,794.58
| Facility | | $25,703.96 | $35,481.34 | $70,794.58 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,479.11 / $2,137.96 / $2,951.21
| Professional | | $1,479.11 | $2,137.96 | $2,951.21 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,677.35 / $37,153.52 / $72,443.60
| Facility | | $4,677.35 | $37,153.52 | $72,443.60 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,071.52 / $1,548.82 / $2,884.03
| Professional | | $1,071.52 | $1,548.82 | $2,884.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,380.38 / $1,380.38 / $1,380.38
| Professional | | $1,380.38 | $1,380.38 | $1,380.38 |