- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,584.89 / $3,311.31 / $14,454.40
| Facility | | $1,584.89 | $3,311.31 | $14,454.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,479.11 / $1,621.81 / $4,073.80
| Professional | | $1,479.11 | $1,621.81 | $4,073.80 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,011.87 / $8,128.31 / $13,182.57
| Facility | | $5,011.87 | $8,128.31 | $13,182.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,621.81 / $3,235.94 / $8,511.38
| Professional | | $1,621.81 | $3,235.94 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,168.69 / $4,897.79 / $7,762.47
| Facility | | $4,168.69 | $4,897.79 | $7,762.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,949.84 / $6,606.93 / $7,413.10
| Professional | | $1,949.84 | $6,606.93 | $7,413.10 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,621.81 / $3,311.31 / $10,471.29
| Facility | | $1,621.81 | $3,311.31 | $10,471.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,884.03 / $3,890.45 / $5,011.87
| Professional | | $2,884.03 | $3,890.45 | $5,011.87 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,621.81 / $3,311.31 / $19,498.45
| Facility | | $1,621.81 | $3,311.31 | $19,498.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,737.80 / $3,019.95 / $12,022.64
| Professional | | $1,737.80 | $3,019.95 | $12,022.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $70.79
| Professional | | $32.36 | $33.11 | $70.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,235.94 / $12,882.50 / $27,542.29
| Facility | | $3,235.94 | $12,882.50 | $27,542.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,995.26 / $3,890.45 / $6,760.83
| Professional | | $1,995.26 | $3,890.45 | $6,760.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,344.23 / $3,548.13 / $5,128.61
| Professional | | $2,344.23 | $3,548.13 | $5,128.61 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,168.69 / $13,182.57 / $13,182.57
| Facility | | $4,168.69 | $13,182.57 | $13,182.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,884.03 / $7,762.47 / $11,748.98
| Professional | | $2,884.03 | $7,762.47 | $11,748.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5,248.07 / $5,248.07 / $5,248.07
| Professional | | $5,248.07 | $5,248.07 | $5,248.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4,466.84 / $8,912.51 / $10,232.93
| Professional | | $4,466.84 | $8,912.51 | $10,232.93 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9,549.93 / $17,378.01 / $23,442.29
| Facility | | $9,549.93 | $17,378.01 | $23,442.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,621.81 / $2,454.71 / $6,606.93
| Professional | | $1,621.81 | $2,454.71 | $6,606.93 |