- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,090.30 / $6,309.57 / $21,877.62
| Facility | | $3,090.30 | $6,309.57 | $21,877.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,445.44 / $1,905.46 / $4,073.80
| Professional | | $1,445.44 | $1,905.46 | $4,073.80 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,165.95 / $8,709.64 / $17,378.01
| Facility | | $6,165.95 | $8,709.64 | $17,378.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,290.87 / $3,235.94 / $4,570.88
| Professional | | $2,290.87 | $3,235.94 | $4,570.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $630.96 / $758.58 / $4,466.84
| Facility | | $630.96 | $758.58 | $4,466.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,621.81 / $2,754.23 / $4,897.79
| Professional | | $1,621.81 | $2,754.23 | $4,897.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,659.59 / $2,818.38 / $4,466.84
| Facility | | $1,659.59 | $2,818.38 | $4,466.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,548.82 / $2,691.53 / $4,168.69
| Professional | | $1,548.82 | $2,691.53 | $4,168.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $676.08
| Professional | | $32.36 | $33.11 | $676.08 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,995.26 / $3,090.30 / $3,235.94
| Facility | | $1,995.26 | $3,090.30 | $3,235.94 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,238.72 / $2,238.72 / $2,290.87
| Facility | | $2,238.72 | $2,238.72 | $2,290.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,290.87 / $3,311.31 / $4,365.16
| Professional | | $2,290.87 | $3,311.31 | $4,365.16 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,025.60 / $8,912.51 / $17,378.01
| Facility | | $6,025.60 | $8,912.51 | $17,378.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,290.87 / $3,235.94 / $4,466.84
| Professional | | $2,290.87 | $3,235.94 | $4,466.84 |
- 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
- $1,659.59 / $2,344.23 / $4,265.80
| Professional | | $1,659.59 | $2,344.23 | $4,265.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,698.24 / $1,778.28 / $3,235.94
| Professional | | $1,698.24 | $1,778.28 | $3,235.94 |