- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,737.80 / $2,951.21 / $14,454.40
| Facility | | $1,737.80 | $2,951.21 | $14,454.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,318.26 / $1,737.80 / $3,548.13
| Professional | | $1,318.26 | $1,737.80 | $3,548.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,606.93 / $10,964.78 / $19,054.61
| Facility | | $6,606.93 | $10,964.78 | $19,054.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,288.25 / $2,754.23 / $6,918.31
| Professional | | $1,288.25 | $2,754.23 | $6,918.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,715.35 / $4,265.80 / $6,918.31
| Facility | | $3,715.35 | $4,265.80 | $6,918.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,778.28 / $4,466.84 / $5,011.87
| Professional | | $1,778.28 | $4,466.84 | $5,011.87 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,659.59 / $7,244.36 / $13,489.63
| Facility | | $1,659.59 | $7,244.36 | $13,489.63 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,511.89 / $3,548.13 / $4,365.16
| Professional | | $2,511.89 | $3,548.13 | $4,365.16 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,659.59 / $2,951.21 / $9,549.93
| Facility | | $1,659.59 | $2,951.21 | $9,549.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,380.38 / $2,570.40 / $9,120.11
| Professional | | $1,380.38 | $2,570.40 | $9,120.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $1,819.70
| Professional | | $32.36 | $33.11 | $1,819.70 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,949.84 / $1,949.84 / $3,019.95
| Facility | | $1,949.84 | $1,949.84 | $3,019.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,819.70 / $3,548.13 / $4,677.35
| Professional | | $1,819.70 | $3,548.13 | $4,677.35 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,584.89 / $3,090.30 / $5,370.32
| Professional | | $1,584.89 | $3,090.30 | $5,370.32 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,630.78 / $30,902.95 / $30,902.95
| Facility | | $3,630.78 | $30,902.95 | $30,902.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,949.84 / $6,456.54 / $10,471.29
| Professional | | $1,949.84 | $6,456.54 | $10,471.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,467.37 / $3,467.37 / $3,467.37
| Professional | | $3,467.37 | $3,467.37 | $3,467.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,019.95 / $7,244.36 / $8,511.38
| Professional | | $3,019.95 | $7,244.36 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,290.87 / $7,079.46 / $19,498.45
| Facility | | $2,290.87 | $7,079.46 | $19,498.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,230.27 / $2,344.23 / $5,623.41
| Professional | | $1,230.27 | $2,344.23 | $5,623.41 |