- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,890.45 / $7,943.28 / $14,454.40
| Facility | | $3,890.45 | $7,943.28 | $14,454.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,995.26 / $2,570.40 / $12,022.64
| Professional | | $1,995.26 | $2,570.40 | $12,022.64 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7,943.28 / $10,471.29 / $20,417.38
| Facility | | $7,943.28 | $10,471.29 | $20,417.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,949.84 / $3,235.94 / $4,365.16
| Professional | | $1,949.84 | $3,235.94 | $4,365.16 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,290.87 / $5,011.87 / $6,606.93
| Professional | | $2,290.87 | $5,011.87 | $6,606.93 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,995.26 / $3,801.89 / $17,782.79
| Facility | | $1,995.26 | $3,801.89 | $17,782.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,884.03 / $4,466.84 / $16,218.10
| Professional | | $2,884.03 | $4,466.84 | $16,218.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4,786.30 / $5,011.87 / $6,760.83
| Professional | | $4,786.30 | $5,011.87 | $6,760.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4,786.30 / $4,786.30 / $4,786.30
| Professional | | $4,786.30 | $4,786.30 | $4,786.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $2,754.23 / $5,623.41
| Professional | | $6.03 | $2,754.23 | $5,623.41 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,235.94 / $4,466.84 / $8,128.31
| Facility | | $3,235.94 | $4,466.84 | $8,128.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,818.38 / $3,890.45 / $5,495.41
| Professional | | $2,818.38 | $3,890.45 | $5,495.41 |