- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,122.02 / $3,715.35 / $12,882.50
| Facility | | $1,122.02 | $3,715.35 | $12,882.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,174.90 / $1,412.54 / $2,137.96
| Professional | | $1,174.90 | $1,412.54 | $2,137.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,096.48 / $1,348.96 / $1,862.09
| Professional | | $1,096.48 | $1,348.96 | $1,862.09 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,096.48 / $1,096.48 / $1,096.48
| Facility | | $1,096.48 | $1,096.48 | $1,096.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,258.93 / $1,659.59 / $2,630.27
| Professional | | $1,258.93 | $1,659.59 | $2,630.27 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $54.95 / $56.23 / $17,782.79
| Facility | | $54.95 | $56.23 | $17,782.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12,882.50 / $12,882.50 / $12,882.50
| Professional | | $12,882.50 | $12,882.50 | $12,882.50 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,096.48 / $2,238.72 / $6,918.31
| Facility | | $1,096.48 | $2,238.72 | $6,918.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,202.26 / $1,698.24 / $3,162.28
| Professional | | $1,202.26 | $1,698.24 | $3,162.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $954.99
| Professional | | $32.36 | $33.11 | $954.99 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,981.07 / $4,073.80 / $4,466.84
| Professional | | $3,981.07 | $4,073.80 | $4,466.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,174.90 / $1,659.59 / $3,090.30
| Facility | | $1,174.90 | $1,659.59 | $3,090.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,258.93 / $1,698.24 / $2,511.89
| Professional | | $1,258.93 | $1,698.24 | $2,511.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,630.27 / $7,079.46 / $14,454.40
| Facility | | $2,630.27 | $7,079.46 | $14,454.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,047.13 / $1,412.54 / $2,187.76
| Professional | | $1,047.13 | $1,412.54 | $2,187.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,096.48 / $1,096.48 / $1,202.26
| Professional | | $1,096.48 | $1,096.48 | $1,202.26 |