- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,290.87 / $7,943.28 / $14,454.40
| Facility | | $2,290.87 | $7,943.28 | $14,454.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,071.52 / $1,412.54 / $6,309.57
| Professional | | $1,071.52 | $1,412.54 | $6,309.57 |
- 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
- $1,047.13 / $1,737.80 / $2,344.23
| Professional | | $1,047.13 | $1,737.80 | $2,344.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,348.96 / $2,630.27 / $3,630.78
| Professional | | $1,348.96 | $2,630.27 | $3,630.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,071.52 / $2,570.40 / $18,197.01
| Facility | | $1,071.52 | $2,570.40 | $18,197.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,584.89 / $2,398.83 / $8,709.64
| Professional | | $1,584.89 | $2,398.83 | $8,709.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,691.53 / $2,754.23 / $3,801.89
| Professional | | $2,691.53 | $2,754.23 | $3,801.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,570.40 / $2,570.40 / $2,570.40
| Professional | | $2,570.40 | $2,570.40 | $2,570.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $2,187.76 / $3,019.95
| Professional | | $12.02 | $2,187.76 | $3,019.95 |
- 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
- $1,548.82 / $2,137.96 / $2,951.21
| Professional | | $1,548.82 | $2,137.96 | $2,951.21 |