- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $794.33 / $1,698.24 / $14,454.40
| Facility | | $794.33 | $1,698.24 | $14,454.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $724.44 / $831.76 / $2,089.30
| Professional | | $724.44 | $831.76 | $2,089.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,011.87 / $8,128.31 / $13,489.63
| Facility | | $5,011.87 | $8,128.31 | $13,489.63 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $794.33 / $1,659.59 / $4,168.69
| Professional | | $794.33 | $1,659.59 | $4,168.69 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,137.96 / $2,511.89 / $3,981.07
| Facility | | $2,137.96 | $2,511.89 | $3,981.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,023.29 / $3,311.31 / $3,801.89
| Professional | | $1,023.29 | $3,311.31 | $3,801.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $812.83 / $1,698.24 / $6,760.83
| Facility | | $812.83 | $1,698.24 | $6,760.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,479.11 / $1,995.26 / $2,570.40
| Professional | | $1,479.11 | $1,995.26 | $2,570.40 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $812.83 / $1,778.28 / $15,135.61
| Facility | | $812.83 | $1,778.28 | $15,135.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $851.14 / $1,513.56 / $6,165.95
| Professional | | $851.14 | $1,513.56 | $6,165.95 |
- 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
- $1,621.81 / $10,715.19 / $17,378.01
| Facility | | $1,621.81 | $10,715.19 | $17,378.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,023.29 / $1,949.84 / $3,235.94
| Professional | | $1,023.29 | $1,949.84 | $3,235.94 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,202.26 / $1,819.70 / $2,691.53
| Professional | | $1,202.26 | $1,819.70 | $2,691.53 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,137.96 / $6,760.83 / $6,760.83
| Facility | | $2,137.96 | $6,760.83 | $6,760.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,445.44 / $3,890.45 / $6,025.60
| Professional | | $1,445.44 | $3,890.45 | $6,025.60 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,570.40 / $2,570.40 / $2,570.40
| Professional | | $2,570.40 | $2,570.40 | $2,570.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,238.72 / $4,466.84 / $5,248.07
| Professional | | $2,238.72 | $4,466.84 | $5,248.07 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8,912.51 / $14,125.38 / $17,782.79
| Facility | | $8,912.51 | $14,125.38 | $17,782.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $812.83 / $1,230.27 / $3,311.31
| Professional | | $812.83 | $1,230.27 | $3,311.31 |