- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $724.44 / $7,244.36 / $12,882.50
| Facility | | $724.44 | $7,244.36 | $12,882.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $223.87 / $407.38 / $1,698.24
| Professional | | $223.87 | $407.38 | $1,698.24 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,495.41 / $8,511.38 / $38,904.51
| Facility | | $5,495.41 | $8,511.38 | $38,904.51 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14,125.38 / $14,125.38 / $57,543.99
| Facility | | $14,125.38 | $14,125.38 | $57,543.99 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $977.24 / $1,862.09 / $2,187.76
| Professional | | $977.24 | $1,862.09 | $2,187.76 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,309.57 / $6,309.57 / $6,309.57
| Facility | | $6,309.57 | $6,309.57 | $6,309.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $251.19 / $467.74 / $2,137.96
| Professional | | $251.19 | $467.74 | $2,137.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,995.26 / $1,995.26 / $2,041.74
| Professional | | $1,995.26 | $1,995.26 | $2,041.74 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $354.81 / $354.81 / $2,754.23
| Facility | | $354.81 | $354.81 | $2,754.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $316.23 / $1,548.82 / $2,137.96
| Professional | | $316.23 | $1,548.82 | $2,137.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,677.35 / $15,135.61 / $28,840.32
| Facility | | $4,677.35 | $15,135.61 | $28,840.32 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $245.47 / $257.04 / $398.11
| Professional | | $245.47 | $257.04 | $398.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,011.87 / $6,606.93 / $16,218.10
| Facility | | $5,011.87 | $6,606.93 | $16,218.10 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $380.19 / $3,715.35 / $10,964.78
| Facility | | $380.19 | $3,715.35 | $10,964.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $239.88 / $1,122.02 / $2,454.71
| Professional | | $239.88 | $1,122.02 | $2,454.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,265.80 / $4,786.30 / $6,606.93
| Facility | | $4,265.80 | $4,786.30 | $6,606.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $234.42 / $1,445.44 / $1,445.44
| Professional | | $234.42 | $1,445.44 | $1,445.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $229.09 / $338.84 / $1,288.25
| Facility | | $229.09 | $338.84 | $1,288.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $223.87 / $338.84 / $1,258.93
| Professional | | $223.87 | $338.84 | $1,258.93 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,019.95 / $6,309.57 / $18,197.01
| Facility | | $3,019.95 | $6,309.57 | $18,197.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $234.42 / $891.25 / $2,041.74
| Professional | | $234.42 | $891.25 | $2,041.74 |