- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,513.56 / $3,311.31 / $6,760.83
| Facility | | $1,513.56 | $3,311.31 | $6,760.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,479.11 / $1,905.46 / $4,570.88
| Professional | | $1,479.11 | $1,905.46 | $4,570.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $56.23 / $5,370.32 / $19,054.61
| Facility | | $56.23 | $5,370.32 | $19,054.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,479.11 / $2,511.89 / $11,748.98
| Professional | | $1,479.11 | $2,511.89 | $11,748.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,949.84 / $3,311.31 / $4,365.16
| Professional | | $1,949.84 | $3,311.31 | $4,365.16 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $20,417.38 / $20,892.96 / $20,892.96
| Facility | | $20,417.38 | $20,892.96 | $20,892.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,548.82 / $2,454.71 / $4,677.35
| Professional | | $1,548.82 | $2,454.71 | $4,677.35 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,380.38 / $2,089.30 / $4,786.30
| Facility | | $1,380.38 | $2,089.30 | $4,786.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,659.59 / $2,041.74 / $2,884.03
| Professional | | $1,659.59 | $2,041.74 | $2,884.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,090.30 / $6,918.31 / $15,488.17
| Facility | | $3,090.30 | $6,918.31 | $15,488.17 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,548.82 / $2,884.03 / $4,570.88
| Professional | | $1,548.82 | $2,884.03 | $4,570.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12,302.69 / $12,302.69 / $42,657.95
| Facility | | $12,302.69 | $12,302.69 | $42,657.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,819.70 / $1,819.70 / $3,630.78
| Professional | | $1,819.70 | $1,819.70 | $3,630.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $56.23 / $5,370.32 / $19,054.61
| Facility | | $56.23 | $5,370.32 | $19,054.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,479.11 / $2,511.89 / $11,748.98
| Professional | | $1,479.11 | $2,511.89 | $11,748.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,570.40 / $6,165.95 / $16,595.87
| Facility | | $2,570.40 | $6,165.95 | $16,595.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,621.81 / $2,570.40 / $4,786.30
| Professional | | $1,621.81 | $2,570.40 | $4,786.30 |