- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,884.03 / $8,317.64 / $23,988.33
| Facility | | $2,884.03 | $8,317.64 | $23,988.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $426.58 / $3,715.35 / $19,952.62
| Professional | | $426.58 | $3,715.35 | $19,952.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $776.25 / $776.25 / $776.25
| Professional | | $776.25 | $776.25 | $776.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,456.54 / $11,481.54 / $17,782.79
| Facility | | $6,456.54 | $11,481.54 | $17,782.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $616.60 / $6,760.83 / $15,848.93
| Professional | | $616.60 | $6,760.83 | $15,848.93 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $85.11 / $1,412.54 / $13,182.57
| Facility | | $85.11 | $1,412.54 | $13,182.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $446.68 / $3,311.31 / $10,964.78
| Professional | | $446.68 | $3,311.31 | $10,964.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8,128.31 / $8,128.31 / $9,549.93
| Facility | | $8,128.31 | $8,128.31 | $9,549.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $478.63 / $1,412.54 / $10,232.93
| Professional | | $478.63 | $1,412.54 | $10,232.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $389.05 / $4,365.16 / $7,943.28
| Professional | | $389.05 | $4,365.16 | $7,943.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $363.08 / $3,801.89 / $8,511.38
| Professional | | $363.08 | $3,801.89 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $54.95 / $56.23 / $38,904.51
| Facility | | $54.95 | $56.23 | $38,904.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $31,622.78 / $36,307.81 / $36,307.81
| Professional | | $31,622.78 | $36,307.81 | $36,307.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,630.78 / $3,630.78 / $6,165.95
| Professional | | $3,630.78 | $3,630.78 | $6,165.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $446.68 / $4,786.30 / $8,709.64
| Facility | | $446.68 | $4,786.30 | $8,709.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $467.74 / $1,318.26 / $10,964.78
| Professional | | $467.74 | $1,318.26 | $10,964.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,412.54 / $1,412.54 / $16,595.87
| Professional | | $1,412.54 | $1,412.54 | $16,595.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $354.81 / $5,011.87 / $7,413.10
| Professional | | $354.81 | $5,011.87 | $7,413.10 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9,332.54 / $17,378.01 / $38,018.94
| Facility | | $9,332.54 | $17,378.01 | $38,018.94 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $416.87 / $3,801.89 / $10,471.29
| Professional | | $416.87 | $3,801.89 | $10,471.29 |