- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $831.76 / $5,623.41 / $14,454.40
| Facility | | $831.76 | $5,623.41 | $14,454.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $457.09 / $2,290.87 / $7,943.28
| Professional | | $457.09 | $2,290.87 | $7,943.28 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,365.16 / $6,760.83 / $47,863.01
| Facility | | $4,365.16 | $6,760.83 | $47,863.01 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $20,417.38 / $21,379.62 / $57,543.99
| Facility | | $20,417.38 | $21,379.62 | $57,543.99 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,630.78 / $7,079.46 / $8,317.64
| Professional | | $3,630.78 | $7,079.46 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $426.58 / $851.14 / $8,128.31
| Professional | | $426.58 | $851.14 | $8,128.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7,413.10 / $7,413.10 / $7,585.78
| Professional | | $7,413.10 | $7,413.10 | $7,585.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $562.34 / $5,623.41 / $7,943.28
| Professional | | $562.34 | $5,623.41 | $7,943.28 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8,511.38 / $23,988.33 / $53,703.18
| Facility | | $8,511.38 | $23,988.33 | $53,703.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $588.84 / $588.84 / $5,623.41
| Professional | | $588.84 | $588.84 | $5,623.41 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,981.07 / $5,495.41 / $23,442.29
| Facility | | $3,981.07 | $5,495.41 | $23,442.29 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $630.96 / $3,890.45 / $10,964.78
| Facility | | $630.96 | $3,890.45 | $10,964.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $457.09 / $1,737.80 / $8,912.51
| Professional | | $457.09 | $1,737.80 | $8,912.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5,128.61 / $5,495.41 / $6,918.31
| Professional | | $5,128.61 | $5,495.41 | $6,918.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $416.87 / $870.96 / $4,677.35
| Facility | | $416.87 | $870.96 | $4,677.35 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $416.87 / $870.96 / $4,677.35
| Professional | | $416.87 | $870.96 | $4,677.35 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,630.78 / $10,964.78 / $37,153.52
| Facility | | $3,630.78 | $10,964.78 | $37,153.52 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $446.68 / $3,311.31 / $7,585.78
| Professional | | $446.68 | $3,311.31 | $7,585.78 |