- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,398.83 / $8,912.51 / $20,892.96
| Facility | | $2,398.83 | $8,912.51 | $20,892.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,174.90 / $1,778.28 / $3,388.44
| Professional | | $1,174.90 | $1,778.28 | $3,388.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,495.41 / $8,511.38 / $17,378.01
| Facility | | $5,495.41 | $8,511.38 | $17,378.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,737.80 / $2,511.89 / $3,235.94
| Professional | | $1,737.80 | $2,511.89 | $3,235.94 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,311.31 / $3,311.31 / $3,311.31
| Facility | | $3,311.31 | $3,311.31 | $3,311.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,513.56 / $2,398.83 / $3,801.89
| Professional | | $1,513.56 | $2,398.83 | $3,801.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,621.81 / $2,818.38 / $8,317.64
| Facility | | $1,621.81 | $2,818.38 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,621.81 / $2,691.53 / $3,548.13
| Professional | | $1,621.81 | $2,691.53 | $3,548.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $64.57
| Professional | | $32.36 | $33.11 | $64.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,445.44 / $2,398.83 / $2,511.89
| Facility | | $1,445.44 | $2,398.83 | $2,511.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,698.24 / $1,698.24 / $1,737.80
| Facility | | $1,698.24 | $1,698.24 | $1,737.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,737.80 / $2,691.53 / $3,630.78
| Professional | | $1,737.80 | $2,691.53 | $3,630.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,888.44 / $8,912.51 / $17,378.01
| Facility | | $5,888.44 | $8,912.51 | $17,378.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,737.80 / $2,511.89 / $3,235.94
| Professional | | $1,737.80 | $2,511.89 | $3,235.94 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,691.53 / $10,471.29 / $19,054.61
| Facility | | $2,691.53 | $10,471.29 | $19,054.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,318.26 / $1,905.46 / $3,467.37
| Professional | | $1,318.26 | $1,905.46 | $3,467.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,258.93 / $1,548.82 / $2,398.83
| Professional | | $1,258.93 | $1,548.82 | $2,398.83 |