- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,137.96 / $3,467.37 / $14,454.40
| Facility | | $2,137.96 | $3,467.37 | $14,454.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,548.82 / $2,137.96 / $5,888.44
| Professional | | $1,548.82 | $2,137.96 | $5,888.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,011.87 / $7,762.47 / $12,589.25
| Facility | | $5,011.87 | $7,762.47 | $12,589.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,659.59 / $3,235.94 / $9,332.54
| Professional | | $1,659.59 | $3,235.94 | $9,332.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,265.80 / $5,011.87 / $7,943.28
| Facility | | $4,265.80 | $5,011.87 | $7,943.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,691.53 / $5,248.07 / $6,606.93
| Professional | | $2,691.53 | $5,248.07 | $6,606.93 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,949.84 / $7,244.36 / $14,454.40
| Facility | | $1,949.84 | $7,244.36 | $14,454.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,548.13 / $4,466.84 / $5,128.61
| Professional | | $3,548.13 | $4,466.84 | $5,128.61 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,819.70 / $3,388.44 / $9,549.93
| Facility | | $1,819.70 | $3,388.44 | $9,549.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,995.26 / $3,467.37 / $9,772.37
| Professional | | $1,995.26 | $3,467.37 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $2,344.23
| Professional | | $32.36 | $33.11 | $2,344.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,511.89 / $2,511.89 / $3,467.37
| Facility | | $2,511.89 | $2,511.89 | $3,467.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,454.71 / $4,897.79 / $7,585.78
| Professional | | $2,454.71 | $4,897.79 | $7,585.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,754.23 / $4,265.80 / $7,244.36
| Professional | | $2,754.23 | $4,265.80 | $7,244.36 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,365.16 / $31,622.78 / $31,622.78
| Facility | | $4,365.16 | $31,622.78 | $31,622.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,884.03 / $8,317.64 / $12,302.69
| Professional | | $2,884.03 | $8,317.64 | $12,302.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8,709.64 / $8,709.64 / $8,709.64
| Professional | | $8,709.64 | $8,709.64 | $8,709.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7,762.47 / $11,748.98 / $11,748.98
| Professional | | $7,762.47 | $11,748.98 | $11,748.98 |
- 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
- $1,995.26 / $3,388.44 / $7,585.78
| Professional | | $1,995.26 | $3,388.44 | $7,585.78 |