- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,513.56 / $3,162.28 / $10,964.78
| Facility | | $1,513.56 | $3,162.28 | $10,964.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,258.93 / $1,513.56 / $3,981.07
| Professional | | $1,258.93 | $1,513.56 | $3,981.07 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,677.35 / $9,772.37 / $18,620.87
| Facility | | $4,677.35 | $9,772.37 | $18,620.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $977.24 / $1,288.25 / $3,162.28
| Professional | | $977.24 | $1,288.25 | $3,162.28 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,659.59 / $1,659.59 / $37,153.52
| Facility | | $1,659.59 | $1,659.59 | $37,153.52 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,659.59 / $1,659.59 / $1,659.59
| Professional | | $1,659.59 | $1,659.59 | $1,659.59 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $34.67 / $5,754.40 / $53,703.18
| Facility | | $34.67 | $5,754.40 | $53,703.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,174.90 / $2,238.72 / $6,025.60
| Professional | | $1,174.90 | $2,238.72 | $6,025.60 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,380.38 / $2,454.71 / $4,466.84
| Facility | | $1,380.38 | $2,454.71 | $4,466.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,202.26 / $1,778.28 / $2,570.40
| Professional | | $1,202.26 | $1,778.28 | $2,570.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $812.83 / $1,348.96 / $2,137.96
| Professional | | $812.83 | $1,348.96 | $2,137.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,288.25 / $50,118.72 / $75,857.76
| Facility | | $1,288.25 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $398.11 / $1,548.82 / $1,905.46
| Professional | | $398.11 | $1,548.82 | $1,905.46 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,479.11 / $4,073.80 / $9,120.11
| Facility | | $1,479.11 | $4,073.80 | $9,120.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,096.48 / $1,698.24 / $4,168.69
| Professional | | $1,096.48 | $1,698.24 | $4,168.69 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $933.25 / $1,479.11 / $4,466.84
| Facility | | $933.25 | $1,479.11 | $4,466.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $812.83 / $1,479.11 / $4,365.16
| Professional | | $812.83 | $1,479.11 | $4,365.16 |