- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,162.28 / $10,232.93 / $26,302.68
| Facility | | $3,162.28 | $10,232.93 | $26,302.68 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,548.82 / $2,137.96 / $4,466.84
| Professional | | $1,548.82 | $2,137.96 | $4,466.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14,125.38 / $18,197.01 / $35,481.34
| Facility | | $14,125.38 | $18,197.01 | $35,481.34 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,344.23 / $3,311.31 / $4,570.88
| Professional | | $2,344.23 | $3,311.31 | $4,570.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $758.58 / $758.58 / $870.96
| Facility | | $758.58 | $758.58 | $870.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,698.24 / $2,754.23 / $5,128.61
| Professional | | $1,698.24 | $2,754.23 | $5,128.61 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,737.80 / $3,467.37 / $10,964.78
| Facility | | $1,737.80 | $3,467.37 | $10,964.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,737.80 / $3,388.44 / $8,317.64
| Professional | | $1,737.80 | $3,388.44 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $691.83
| Professional | | $32.36 | $33.11 | $691.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,089.30 / $3,311.31 / $3,311.31
| Facility | | $2,089.30 | $3,311.31 | $3,311.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,290.87 / $2,290.87 / $2,344.23
| Facility | | $2,290.87 | $2,290.87 | $2,344.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,344.23 / $3,388.44 / $4,466.84
| Professional | | $2,344.23 | $3,388.44 | $4,466.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12,882.50 / $18,197.01 / $35,481.34
| Facility | | $12,882.50 | $18,197.01 | $35,481.34 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,344.23 / $3,311.31 / $4,570.88
| Professional | | $2,344.23 | $3,311.31 | $4,570.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,677.35 / $20,892.96 / $41,686.94
| Facility | | $4,677.35 | $20,892.96 | $41,686.94 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,737.80 / $2,454.71 / $4,466.84
| Professional | | $1,737.80 | $2,454.71 | $4,466.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,659.59 / $1,737.80 / $3,162.28
| Professional | | $1,659.59 | $1,737.80 | $3,162.28 |