- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,995.26 / $7,943.28 / $20,892.96
| Facility | | $1,995.26 | $7,943.28 | $20,892.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $954.99 / $1,348.96 / $2,630.27
| Professional | | $954.99 | $1,348.96 | $2,630.27 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,370.32 / $7,585.78 / $15,488.17
| Facility | | $5,370.32 | $7,585.78 | $15,488.17 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,445.44 / $2,041.74 / $2,884.03
| Professional | | $1,445.44 | $2,041.74 | $2,884.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $707.95 / $1,995.26 / $3,388.44
| Facility | | $707.95 | $1,995.26 | $3,388.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,047.13 / $1,737.80 / $3,162.28
| Professional | | $1,047.13 | $1,737.80 | $3,162.28 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,148.15 / $1,995.26 / $3,235.94
| Facility | | $1,148.15 | $1,995.26 | $3,235.94 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,122.02 / $1,819.70 / $2,691.53
| Professional | | $1,122.02 | $1,819.70 | $2,691.53 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $33.11
| Professional | | $32.36 | $33.11 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,548.82 / $2,041.74 / $2,137.96
| Facility | | $1,548.82 | $2,041.74 | $2,137.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,412.54 / $1,412.54 / $1,445.44
| Facility | | $1,412.54 | $1,412.54 | $1,445.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,445.44 / $2,137.96 / $2,754.23
| Professional | | $1,445.44 | $2,137.96 | $2,754.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,248.07 / $7,943.28 / $15,488.17
| Facility | | $5,248.07 | $7,943.28 | $15,488.17 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,445.44 / $2,041.74 / $2,884.03
| Professional | | $1,445.44 | $2,041.74 | $2,884.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,137.96 / $8,912.51 / $16,595.87
| Facility | | $2,137.96 | $8,912.51 | $16,595.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,071.52 / $1,513.56 / $2,754.23
| Professional | | $1,071.52 | $1,513.56 | $2,754.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,071.52 / $1,122.02 / $2,041.74
| Professional | | $1,071.52 | $1,122.02 | $2,041.74 |