- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,570.40 / $4,168.69 / $14,454.40
| Facility | | $2,570.40 | $4,168.69 | $14,454.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,905.46 / $2,570.40 / $7,244.36
| Professional | | $1,905.46 | $2,570.40 | $7,244.36 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12,882.50 / $18,197.01 / $28,840.32
| Facility | | $12,882.50 | $18,197.01 | $28,840.32 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,041.74 / $3,890.45 / $11,481.54
| Professional | | $2,041.74 | $3,890.45 | $11,481.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,248.07 / $6,025.60 / $9,772.37
| Facility | | $5,248.07 | $6,025.60 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,235.94 / $6,456.54 / $7,244.36
| Professional | | $3,235.94 | $6,456.54 | $7,244.36 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,398.83 / $7,244.36 / $14,454.40
| Facility | | $2,398.83 | $7,244.36 | $14,454.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4,365.16 / $5,370.32 / $6,309.57
| Professional | | $4,365.16 | $5,370.32 | $6,309.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,187.76 / $3,890.45 / $9,549.93
| Facility | | $2,187.76 | $3,890.45 | $9,549.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,398.83 / $4,265.80 / $12,022.64
| Professional | | $2,398.83 | $4,265.80 | $12,022.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $2,818.38
| Professional | | $32.36 | $33.11 | $2,818.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,019.95 / $3,019.95 / $4,265.80
| Facility | | $3,019.95 | $3,019.95 | $4,265.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,951.21 / $6,025.60 / $9,332.54
| Professional | | $2,951.21 | $6,025.60 | $9,332.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,311.31 / $5,128.61 / $8,709.64
| Professional | | $3,311.31 | $5,128.61 | $8,709.64 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,248.07 / $50,118.72 / $50,118.72
| Facility | | $5,248.07 | $50,118.72 | $50,118.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,548.13 / $10,232.93 / $19,054.61
| Professional | | $3,548.13 | $10,232.93 | $19,054.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10,715.19 / $10,715.19 / $10,715.19
| Professional | | $10,715.19 | $10,715.19 | $10,715.19 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9,120.11 / $14,125.38 / $14,125.38
| Professional | | $9,120.11 | $14,125.38 | $14,125.38 |
- 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
- $2,290.87 / $4,168.69 / $9,120.11
| Professional | | $2,290.87 | $4,168.69 | $9,120.11 |