- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,659.59 / $8,128.31 / $20,892.96
| Facility | | $1,659.59 | $8,128.31 | $20,892.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $741.31 / $1,096.48 / $2,187.76
| Professional | | $741.31 | $1,096.48 | $2,187.76 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,456.54 / $8,317.64 / $16,218.10
| Facility | | $6,456.54 | $8,317.64 | $16,218.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,202.26 / $1,698.24 / $2,290.87
| Professional | | $1,202.26 | $1,698.24 | $2,290.87 |
- 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
- $812.83 / $1,412.54 / $2,511.89
| Professional | | $812.83 | $1,412.54 | $2,511.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $794.33 / $1,659.59 / $3,890.45
| Facility | | $794.33 | $1,659.59 | $3,890.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $794.33 / $1,621.81 / $2,951.21
| Professional | | $794.33 | $1,621.81 | $2,951.21 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $354.81
| Professional | | $32.36 | $33.11 | $354.81 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $954.99 / $1,584.89 / $1,698.24
| Facility | | $954.99 | $1,584.89 | $1,698.24 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,174.90 / $1,174.90 / $1,202.26
| Facility | | $1,174.90 | $1,174.90 | $1,202.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,202.26 / $1,737.80 / $2,290.87
| Professional | | $1,202.26 | $1,737.80 | $2,290.87 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,888.44 / $8,317.64 / $16,218.10
| Facility | | $5,888.44 | $8,317.64 | $16,218.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,202.26 / $1,698.24 / $2,290.87
| Professional | | $1,202.26 | $1,698.24 | $2,290.87 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,884.03 / $10,232.93 / $18,620.87
| Facility | | $2,884.03 | $10,232.93 | $18,620.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $831.76 / $1,174.90 / $2,187.76
| Professional | | $831.76 | $1,174.90 | $2,187.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $954.99 / $977.24 / $1,819.70
| Professional | | $954.99 | $977.24 | $1,819.70 |