- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,819.70 / $3,801.89 / $10,964.78
| Facility | | $1,819.70 | $3,801.89 | $10,964.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,513.56 / $1,995.26 / $5,128.61
| Professional | | $1,513.56 | $1,995.26 | $5,128.61 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,011.87 / $10,715.19 / $19,054.61
| Facility | | $5,011.87 | $10,715.19 | $19,054.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,318.26 / $1,698.24 / $4,168.69
| Professional | | $1,318.26 | $1,698.24 | $4,168.69 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,187.76 / $2,187.76 / $37,153.52
| Facility | | $2,187.76 | $2,187.76 | $37,153.52 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,187.76 / $2,187.76 / $2,187.76
| Professional | | $2,187.76 | $2,187.76 | $2,187.76 |
- 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
- $1,548.82 / $2,818.38 / $6,309.57
| Professional | | $1,548.82 | $2,818.38 | $6,309.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,737.80 / $2,570.40 / $5,623.41
| Facility | | $1,737.80 | $2,570.40 | $5,623.41 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,513.56 / $2,290.87 / $3,235.94
| Professional | | $1,513.56 | $2,290.87 | $3,235.94 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,047.13 / $1,778.28 / $2,818.38
| Professional | | $1,047.13 | $1,778.28 | $2,818.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,318.26 / $50,118.72 / $75,857.76
| Facility | | $1,318.26 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $398.11 / $2,089.30 / $2,570.40
| Professional | | $398.11 | $2,089.30 | $2,570.40 |
- 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
- $1,412.54 / $2,137.96 / $5,623.41
| Professional | | $1,412.54 | $2,137.96 | $5,623.41 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,230.27 / $1,949.84 / $4,570.88
| Facility | | $1,230.27 | $1,949.84 | $4,570.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,047.13 / $1,949.84 / $5,754.40
| Professional | | $1,047.13 | $1,949.84 | $5,754.40 |