- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,884.03 / $4,466.84 / $5,495.41
| Facility | | $2,884.03 | $4,466.84 | $5,495.41 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,174.90 / $1,621.81 / $2,570.40
| Professional | | $1,174.90 | $1,621.81 | $2,570.40 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,981.07 / $10,715.19 / $34,673.69
| Facility | | $3,981.07 | $10,715.19 | $34,673.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,089.30 / $2,454.71 / $2,570.40
| Professional | | $2,089.30 | $2,454.71 | $2,570.40 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12,022.64 / $12,022.64 / $12,022.64
| Facility | | $12,022.64 | $12,022.64 | $12,022.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,174.90 / $1,698.24 / $2,238.72
| Professional | | $1,174.90 | $1,698.24 | $2,238.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,174.90 / $2,041.74 / $3,311.31
| Facility | | $1,174.90 | $2,041.74 | $3,311.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,949.84 / $2,187.76 / $2,951.21
| Professional | | $1,949.84 | $2,187.76 | $2,951.21 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $32.36 / $33.11
| Professional | | $32.36 | $32.36 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $23,988.33 / $29,512.09 / $45,708.82
| Facility | | $23,988.33 | $29,512.09 | $45,708.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,862.09 / $2,570.40 / $3,019.95
| Professional | | $1,862.09 | $2,570.40 | $3,019.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,071.52 / $1,479.11 / $20,417.38
| Professional | | $1,071.52 | $1,479.11 | $20,417.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,570.40 / $26,302.68 / $29,512.09
| Facility | | $2,570.40 | $26,302.68 | $29,512.09 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,230.27 / $1,862.09 / $2,754.23
| Professional | | $1,230.27 | $1,862.09 | $2,754.23 |