- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,819.70 / $7,762.47 / $20,892.96
| Facility | | $1,819.70 | $7,762.47 | $20,892.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $870.96 / $1,230.27 / $2,398.83
| Professional | | $870.96 | $1,230.27 | $2,398.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12,022.64 / $18,197.01 / $35,481.34
| Facility | | $12,022.64 | $18,197.01 | $35,481.34 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,318.26 / $1,905.46 / $2,630.27
| Professional | | $1,318.26 | $1,905.46 | $2,630.27 |
- 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
- $933.25 / $1,584.89 / $2,884.03
| Professional | | $933.25 | $1,584.89 | $2,884.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $954.99 / $1,905.46 / $8,709.64
| Facility | | $954.99 | $1,905.46 | $8,709.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $954.99 / $1,862.09 / $6,606.93
| Professional | | $954.99 | $1,862.09 | $6,606.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $407.38
| Professional | | $32.36 | $33.11 | $407.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,122.02 / $1,862.09 / $1,949.84
| Facility | | $1,122.02 | $1,862.09 | $1,949.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,288.25 / $1,288.25 / $1,318.26
| Facility | | $1,288.25 | $1,288.25 | $1,318.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,318.26 / $1,949.84 / $2,511.89
| Professional | | $1,318.26 | $1,949.84 | $2,511.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12,882.50 / $18,620.87 / $35,481.34
| Facility | | $12,882.50 | $18,620.87 | $35,481.34 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,318.26 / $1,905.46 / $2,630.27
| Professional | | $1,318.26 | $1,905.46 | $2,630.27 |
- 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
- $954.99 / $1,380.38 / $2,511.89
| Professional | | $954.99 | $1,380.38 | $2,511.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $977.24 / $1,023.29 / $1,862.09
| Professional | | $977.24 | $1,023.29 | $1,862.09 |