- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,951.21 / $7,413.10 / $18,197.01
| Facility | | $2,951.21 | $7,413.10 | $18,197.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $912.01 / $1,096.48 / $5,370.32
| Professional | | $912.01 | $1,096.48 | $5,370.32 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,630.78 / $6,165.95 / $13,489.63
| Facility | | $3,630.78 | $6,165.95 | $13,489.63 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,096.48 / $1,479.11 / $2,884.03
| Professional | | $1,096.48 | $1,479.11 | $2,884.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $85.11 / $5,623.41 / $10,232.93
| Facility | | $85.11 | $5,623.41 | $10,232.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $851.14 / $1,202.26 / $2,630.27
| Professional | | $851.14 | $1,202.26 | $2,630.27 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,090.30 / $3,090.30 / $3,090.30
| Facility | | $3,090.30 | $3,090.30 | $3,090.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $870.96 / $1,230.27 / $2,570.40
| Professional | | $870.96 | $1,230.27 | $2,570.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $724.44 / $1,023.29 / $1,380.38
| Professional | | $724.44 | $1,023.29 | $1,380.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $831.76 / $1,096.48 / $2,187.76
| Professional | | $831.76 | $1,096.48 | $2,187.76 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9,332.54 / $9,332.54 / $45,708.82
| Facility | | $9,332.54 | $9,332.54 | $45,708.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7,413.10 / $8,128.31 / $8,128.31
| Professional | | $7,413.10 | $8,128.31 | $8,128.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,445.44 / $1,445.44 / $1,445.44
| Professional | | $1,445.44 | $1,445.44 | $1,445.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $54.95 / $54.95 / $70.79
| Professional | | $54.95 | $54.95 | $70.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $933.25 / $1,230.27 / $1,949.84
| Facility | | $933.25 | $1,230.27 | $1,949.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $870.96 / $1,230.27 / $2,570.40
| Professional | | $870.96 | $1,230.27 | $2,570.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,311.31 / $3,311.31 / $3,311.31
| Professional | | $3,311.31 | $3,311.31 | $3,311.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $831.76 / $1,096.48 / $1,548.82
| Professional | | $831.76 | $1,096.48 | $1,548.82 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,248.07 / $9,772.37 / $20,417.38
| Facility | | $5,248.07 | $9,772.37 | $20,417.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $758.58 / $1,047.13 / $2,290.87
| Professional | | $758.58 | $1,047.13 | $2,290.87 |