- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,162.28 / $8,912.51 / $20,892.96
| Facility | | $3,162.28 | $8,912.51 | $20,892.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,548.82 / $2,344.23 / $4,168.69
| Professional | | $1,548.82 | $2,344.23 | $4,168.69 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10,715.19 / $15,488.17 / $31,622.78
| Facility | | $10,715.19 | $15,488.17 | $31,622.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,344.23 / $3,311.31 / $4,365.16
| Professional | | $2,344.23 | $3,311.31 | $4,365.16 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,168.69 / $4,168.69 / $6,918.31
| Facility | | $4,168.69 | $4,168.69 | $6,918.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,949.84 / $3,235.94 / $5,128.61
| Professional | | $1,949.84 | $3,235.94 | $5,128.61 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,137.96 / $3,890.45 / $15,848.93
| Facility | | $2,137.96 | $3,890.45 | $15,848.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,137.96 / $3,630.78 / $5,495.41
| Professional | | $2,137.96 | $3,630.78 | $5,495.41 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $33.11
| Professional | | $32.36 | $33.11 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,041.74 / $3,235.94 / $3,311.31
| Facility | | $2,041.74 | $3,235.94 | $3,311.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,290.87 / $2,290.87 / $2,290.87
| Facility | | $2,290.87 | $2,290.87 | $2,290.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,290.87 / $3,630.78 / $4,897.79
| Professional | | $2,290.87 | $3,630.78 | $4,897.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10,964.78 / $16,218.10 / $31,622.78
| Facility | | $10,964.78 | $16,218.10 | $31,622.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,344.23 / $3,311.31 / $4,365.16
| Professional | | $2,344.23 | $3,311.31 | $4,365.16 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,011.87 / $18,197.01 / $33,884.42
| Facility | | $5,011.87 | $18,197.01 | $33,884.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,737.80 / $2,630.27 / $4,570.88
| Professional | | $1,737.80 | $2,630.27 | $4,570.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,659.59 / $2,041.74 / $3,162.28
| Professional | | $1,659.59 | $2,041.74 | $3,162.28 |