- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,818.38 / $7,413.10 / $18,197.01
| Facility | | $2,818.38 | $7,413.10 | $18,197.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $812.83 / $1,047.13 / $5,128.61
| Professional | | $812.83 | $1,047.13 | $5,128.61 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,570.88 / $8,128.31 / $15,848.93
| Facility | | $4,570.88 | $8,128.31 | $15,848.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,023.29 / $1,380.38 / $2,754.23
| Professional | | $1,023.29 | $1,380.38 | $2,754.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $85.11 / $6,025.60 / $10,471.29
| Facility | | $85.11 | $6,025.60 | $10,471.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $977.24 / $1,380.38 / $2,818.38
| Professional | | $977.24 | $1,380.38 | $2,818.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,090.30 / $3,090.30 / $3,090.30
| Facility | | $3,090.30 | $3,090.30 | $3,090.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $912.01 / $1,202.26 / $2,570.40
| Professional | | $912.01 | $1,202.26 | $2,570.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $501.19 / $1,148.15 / $1,548.82
| Professional | | $501.19 | $1,148.15 | $1,548.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $891.25 / $1,174.90 / $2,754.23
| Professional | | $891.25 | $1,174.90 | $2,754.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9,332.54 / $9,332.54 / $45,708.82
| Facility | | $9,332.54 | $9,332.54 | $45,708.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7,079.46 / $8,511.38 / $8,511.38
| Professional | | $7,079.46 | $8,511.38 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,412.54 / $1,412.54 / $1,412.54
| Professional | | $1,412.54 | $1,412.54 | $1,412.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $54.95 / $54.95 / $70.79
| Professional | | $54.95 | $54.95 | $70.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $954.99 / $1,230.27 / $1,949.84
| Facility | | $954.99 | $1,230.27 | $1,949.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $933.25 / $1,230.27 / $2,570.40
| Professional | | $933.25 | $1,230.27 | $2,570.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,162.28 / $3,162.28 / $3,162.28
| Professional | | $3,162.28 | $3,162.28 | $3,162.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $630.96 / $891.25 / $1,148.15
| Professional | | $630.96 | $891.25 | $1,148.15 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,128.61 / $9,549.93 / $20,417.38
| Facility | | $5,128.61 | $9,549.93 | $20,417.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $741.31 / $1,000.00 / $2,290.87
| Professional | | $741.31 | $1,000.00 | $2,290.87 |