- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,011.87 / $7,943.28 / $14,454.40
| Facility | | $5,011.87 | $7,943.28 | $14,454.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,174.90 / $1,737.80 / $7,079.46
| Professional | | $1,174.90 | $1,737.80 | $7,079.46 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8,128.31 / $10,715.19 / $20,892.96
| Facility | | $8,128.31 | $10,715.19 | $20,892.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,174.90 / $1,995.26 / $2,818.38
| Professional | | $1,174.90 | $1,995.26 | $2,818.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13,182.57 / $13,182.57 / $13,182.57
| Facility | | $13,182.57 | $13,182.57 | $13,182.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,380.38 / $2,884.03 / $3,715.35
| Professional | | $1,380.38 | $2,884.03 | $3,715.35 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,174.90 / $2,187.76 / $19,054.61
| Facility | | $1,174.90 | $2,187.76 | $19,054.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,348.96 / $2,344.23 / $9,549.93
| Professional | | $1,348.96 | $2,344.23 | $9,549.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,454.71 / $2,884.03 / $4,073.80
| Professional | | $2,454.71 | $2,884.03 | $4,073.80 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13,182.57 / $13,182.57 / $13,182.57
| Facility | | $13,182.57 | $13,182.57 | $13,182.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,454.71 / $2,818.38 / $4,073.80
| Professional | | $2,454.71 | $2,818.38 | $4,073.80 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7,079.46 / $9,772.37 / $19,498.45
| Facility | | $7,079.46 | $9,772.37 | $19,498.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,479.11 / $2,290.87 / $3,162.28
| Professional | | $1,479.11 | $2,290.87 | $3,162.28 |