- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,071.52 / $3,801.89 / $12,882.50
| Facility | | $1,071.52 | $3,801.89 | $12,882.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $741.31 / $870.96 / $1,445.44
| Professional | | $741.31 | $870.96 | $1,445.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,162.28 / $8,912.51 / $15,848.93
| Facility | | $3,162.28 | $8,912.51 | $15,848.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $758.58 / $933.25 / $1,288.25
| Professional | | $758.58 | $933.25 | $1,288.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $575.44 / $575.44 / $776.25
| Facility | | $575.44 | $575.44 | $776.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,380.38 / $1,380.38 / $1,380.38
| Facility | | $1,380.38 | $1,380.38 | $1,380.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $776.25 / $1,071.52 / $1,698.24
| Professional | | $776.25 | $1,071.52 | $1,698.24 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $20,892.96 / $33,884.42 / $33,884.42
| Facility | | $20,892.96 | $33,884.42 | $33,884.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6,309.57 / $7,079.46 / $7,079.46
| Professional | | $6,309.57 | $7,079.46 | $7,079.46 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $812.83 / $1,202.26 / $4,570.88
| Facility | | $812.83 | $1,202.26 | $4,570.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $776.25 / $1,096.48 / $1,737.80
| Professional | | $776.25 | $1,096.48 | $1,737.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $107.15 / $707.95
| Professional | | $32.36 | $107.15 | $707.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,122.02 / $2,951.21 / $3,090.30
| Professional | | $1,122.02 | $2,951.21 | $3,090.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $794.33 / $1,096.48 / $1,778.28
| Facility | | $794.33 | $1,096.48 | $1,778.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $758.58 / $1,071.52 / $1,698.24
| Professional | | $758.58 | $1,071.52 | $1,698.24 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,737.80 / $5,248.07 / $10,232.93
| Facility | | $1,737.80 | $5,248.07 | $10,232.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $660.69 / $870.96 / $1,348.96
| Professional | | $660.69 | $870.96 | $1,348.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $776.25 / $794.33 / $812.83
| Professional | | $776.25 | $794.33 | $812.83 |