- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,456.54 / $7,943.28 / $14,454.40
| Facility | | $6,456.54 | $7,943.28 | $14,454.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,090.30 / $3,981.07 / $17,782.79
| Professional | | $3,090.30 | $3,981.07 | $17,782.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9,120.11 / $12,022.64 / $23,442.29
| Facility | | $9,120.11 | $12,022.64 | $23,442.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,951.21 / $5,011.87 / $6,760.83
| Professional | | $2,951.21 | $5,011.87 | $6,760.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,890.45 / $7,413.10 / $10,232.93
| Professional | | $3,890.45 | $7,413.10 | $10,232.93 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,090.30 / $5,128.61 / $64,565.42
| Facility | | $3,090.30 | $5,128.61 | $64,565.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4,570.88 / $6,918.31 / $25,118.86
| Professional | | $4,570.88 | $6,918.31 | $25,118.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7,585.78 / $7,943.28 / $10,715.19
| Professional | | $7,585.78 | $7,943.28 | $10,715.19 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7,244.36 / $7,244.36 / $7,244.36
| Professional | | $7,244.36 | $7,244.36 | $7,244.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.14 / $2,951.21 / $8,709.64
| Professional | | $15.14 | $2,951.21 | $8,709.64 |
- 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
- $4,466.84 / $6,165.95 / $8,511.38
| Professional | | $4,466.84 | $6,165.95 | $8,511.38 |