- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,238.72 / $3,801.89 / $10,964.78
| Facility | | $2,238.72 | $3,801.89 | $10,964.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,089.30 / $2,511.89 / $6,606.93
| Professional | | $2,089.30 | $2,511.89 | $6,606.93 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,011.87 / $10,964.78 / $19,054.61
| Facility | | $5,011.87 | $10,964.78 | $19,054.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,621.81 / $2,089.30 / $5,128.61
| Professional | | $1,621.81 | $2,089.30 | $5,128.61 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,691.53 / $2,691.53 / $37,153.52
| Facility | | $2,691.53 | $2,691.53 | $37,153.52 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,691.53 / $2,691.53 / $2,691.53
| Professional | | $2,691.53 | $2,691.53 | $2,691.53 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $34.67 / $7,762.47 / $53,703.18
| Facility | | $34.67 | $7,762.47 | $53,703.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,995.26 / $3,715.35 / $9,772.37
| Professional | | $1,995.26 | $3,715.35 | $9,772.37 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,187.76 / $3,890.45 / $7,079.46
| Facility | | $2,187.76 | $3,890.45 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,905.46 / $2,884.03 / $4,073.80
| Professional | | $1,905.46 | $2,884.03 | $4,073.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,318.26 / $2,238.72 / $3,548.13
| Professional | | $1,318.26 | $2,238.72 | $3,548.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,089.30 / $50,118.72 / $75,857.76
| Facility | | $2,089.30 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $398.11 / $2,511.89 / $3,162.28
| Professional | | $398.11 | $2,511.89 | $3,162.28 |
- 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
- $1,778.28 / $2,754.23 / $6,918.31
| Professional | | $1,778.28 | $2,754.23 | $6,918.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,548.82 / $2,398.83 / $7,244.36
| Facility | | $1,548.82 | $2,398.83 | $7,244.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,318.26 / $2,398.83 / $7,244.36
| Professional | | $1,318.26 | $2,398.83 | $7,244.36 |