- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,818.38 / $7,413.10 / $18,197.01
| Facility | | $2,818.38 | $7,413.10 | $18,197.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $288.40 / $1,148.15 / $3,630.78
| Professional | | $288.40 | $1,148.15 | $3,630.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,548.13 / $6,165.95 / $13,489.63
| Facility | | $3,548.13 | $6,165.95 | $13,489.63 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $436.52 / $1,737.80 / $3,801.89
| Professional | | $436.52 | $1,737.80 | $3,801.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $85.11 / $3,715.35 / $7,244.36
| Facility | | $85.11 | $3,715.35 | $7,244.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $316.23 / $1,096.48 / $2,884.03
| Professional | | $316.23 | $1,096.48 | $2,884.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,995.26 / $1,995.26 / $2,398.83
| Facility | | $1,995.26 | $1,995.26 | $2,398.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $295.12 / $933.25 / $2,454.71
| Professional | | $295.12 | $933.25 | $2,454.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $331.13 / $416.87 / $2,398.83
| Professional | | $331.13 | $416.87 | $2,398.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $295.12 / $1,445.44 / $2,818.38
| Professional | | $295.12 | $1,445.44 | $2,818.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9,120.11 / $45,708.82 / $45,708.82
| Facility | | $9,120.11 | $45,708.82 | $45,708.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9,332.54 / $10,964.78 / $10,964.78
| Professional | | $9,332.54 | $10,964.78 | $10,964.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $912.01 / $912.01 / $1,513.56
| Professional | | $912.01 | $912.01 | $1,513.56 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $346.74 / $1,174.90 / $2,454.71
| Facility | | $346.74 | $1,174.90 | $2,454.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $295.12 / $851.14 / $2,630.27
| Professional | | $295.12 | $851.14 | $2,630.27 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $870.96 / $870.96 / $3,715.35
| Professional | | $870.96 | $870.96 | $3,715.35 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $295.12 / $691.83 / $1,698.24
| Professional | | $295.12 | $691.83 | $1,698.24 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,248.07 / $9,772.37 / $21,379.62
| Facility | | $5,248.07 | $9,772.37 | $21,379.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $257.04 / $912.01 / $2,398.83
| Professional | | $257.04 | $912.01 | $2,398.83 |