- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,905.46 / $5,754.40 / $12,022.64
| Facility | | $1,905.46 | $5,754.40 | $12,022.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,445.44 / $1,995.26 / $2,454.71
| Professional | | $1,445.44 | $1,995.26 | $2,454.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,128.61 / $11,481.54 / $26,302.68
| Facility | | $5,128.61 | $11,481.54 | $26,302.68 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,995.26 / $2,511.89 / $4,466.84
| Professional | | $1,995.26 | $2,511.89 | $4,466.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,290.87 / $2,290.87 / $18,620.87
| Facility | | $2,290.87 | $2,290.87 | $18,620.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,290.87 / $2,290.87 / $2,290.87
| Professional | | $2,290.87 | $2,290.87 | $2,290.87 |
- 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
- $1,659.59 / $3,311.31 / $7,943.28
| Professional | | $1,659.59 | $3,311.31 | $7,943.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $870.96 / $870.96 / $870.96
| Professional | | $870.96 | $870.96 | $870.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $977.24 / $1,905.46 / $3,090.30
| Professional | | $977.24 | $1,905.46 | $3,090.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,548.82 / $50,118.72 / $75,857.76
| Facility | | $1,548.82 | $50,118.72 | $75,857.76 |
- 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
- $1,318.26 / $2,041.74 / $4,897.79
| Professional | | $1,318.26 | $2,041.74 | $4,897.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,380.38 / $1,995.26 / $2,137.96
| Facility | | $1,380.38 | $1,995.26 | $2,137.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $977.24 / $1,905.46 / $3,801.89
| Professional | | $977.24 | $1,905.46 | $3,801.89 |