- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,265.80 / $11,220.18 / $26,915.35
| Facility | | $4,265.80 | $11,220.18 | $26,915.35 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $288.40 / $1,479.11 / $5,128.61
| Professional | | $288.40 | $1,479.11 | $5,128.61 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,630.78 / $6,165.95 / $13,489.63
| Facility | | $3,630.78 | $6,165.95 | $13,489.63 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $478.63 / $2,951.21 / $6,165.95
| Professional | | $478.63 | $2,951.21 | $6,165.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $85.11 / $6,309.57 / $10,715.19
| Facility | | $85.11 | $6,309.57 | $10,715.19 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $302.00 / $1,584.89 / $4,897.79
| Professional | | $302.00 | $1,584.89 | $4,897.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,388.44 / $3,388.44 / $3,981.07
| Facility | | $3,388.44 | $3,388.44 | $3,981.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $309.03 / $933.25 / $3,630.78
| Professional | | $309.03 | $933.25 | $3,630.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $263.03 / $2,238.72 / $3,311.31
| Professional | | $263.03 | $2,238.72 | $3,311.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $245.47 / $1,288.25 / $2,570.40
| Professional | | $245.47 | $1,288.25 | $2,570.40 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $54.95 / $56.23 / $15,135.61
| Facility | | $54.95 | $56.23 | $15,135.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12,022.64 / $12,022.64 / $14,125.38
| Professional | | $12,022.64 | $12,022.64 | $14,125.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,148.15 / $1,148.15 / $1,949.84
| Professional | | $1,148.15 | $1,148.15 | $1,949.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $302.00 / $1,584.89 / $3,235.94
| Facility | | $302.00 | $1,584.89 | $3,235.94 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $309.03 / $851.14 / $3,715.35
| Professional | | $309.03 | $851.14 | $3,715.35 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $891.25 / $891.25 / $5,495.41
| Professional | | $891.25 | $891.25 | $5,495.41 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $239.88 / $2,818.38 / $4,168.69
| Professional | | $239.88 | $2,818.38 | $4,168.69 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,248.07 / $9,772.37 / $20,417.38
| Facility | | $5,248.07 | $9,772.37 | $20,417.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $269.15 / $1,318.26 / $3,715.35
| Professional | | $269.15 | $1,318.26 | $3,715.35 |