- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,025.60 / $7,943.28 / $14,454.40
| Facility | | $6,025.60 | $7,943.28 | $14,454.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,318.26 / $1,659.59 / $7,762.47
| Professional | | $1,318.26 | $1,659.59 | $7,762.47 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,165.95 / $8,128.31 / $15,848.93
| Facility | | $6,165.95 | $8,128.31 | $15,848.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,258.93 / $2,137.96 / $3,162.28
| Professional | | $1,258.93 | $2,137.96 | $3,162.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,548.82 / $3,235.94 / $4,168.69
| Professional | | $1,548.82 | $3,235.94 | $4,168.69 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,659.59 / $3,235.94 / $9,772.37
| Facility | | $1,659.59 | $3,235.94 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,862.09 / $2,818.38 / $10,471.29
| Professional | | $1,862.09 | $2,818.38 | $10,471.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,090.30 / $3,162.28 / $4,365.16
| Professional | | $3,090.30 | $3,162.28 | $4,365.16 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,090.30 / $3,090.30 / $3,090.30
| Professional | | $3,090.30 | $3,090.30 | $3,090.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $2,290.87 / $3,715.35
| Professional | | $6.03 | $2,290.87 | $3,715.35 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,677.35 / $7,413.10 / $9,120.11
| Facility | | $4,677.35 | $7,413.10 | $9,120.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,819.70 / $2,511.89 / $3,467.37
| Professional | | $1,819.70 | $2,511.89 | $3,467.37 |