- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,089.30 / $3,715.35 / $11,220.18
| Facility | | $2,089.30 | $3,715.35 | $11,220.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $457.09 / $1,348.96 / $12,302.69
| Professional | | $457.09 | $1,348.96 | $12,302.69 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $56.23 / $5,128.61 / $26,302.68
| Facility | | $56.23 | $5,128.61 | $26,302.68 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $489.78 / $5,754.40 / $20,417.38
| Professional | | $489.78 | $5,754.40 | $20,417.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $524.81 / $524.81 / $1,202.26
| Facility | | $524.81 | $524.81 | $1,202.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $691.83 / $3,090.30 / $15,488.17
| Professional | | $691.83 | $3,090.30 | $15,488.17 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $602.56 / $3,388.44 / $19,952.62
| Professional | | $602.56 | $3,388.44 | $19,952.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $457.09 / $602.56 / $4,897.79
| Facility | | $457.09 | $602.56 | $4,897.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8,128.31 / $9,772.37 / $14,454.40
| Professional | | $8,128.31 | $9,772.37 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,467.37 / $6,918.31 / $20,417.38
| Facility | | $3,467.37 | $6,918.31 | $20,417.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $501.19 / $6,918.31 / $17,378.01
| Professional | | $501.19 | $6,918.31 | $17,378.01 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,981.07 / $4,168.69 / $28,840.32
| Facility | | $3,981.07 | $4,168.69 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $56.23 / $5,128.61 / $26,302.68
| Facility | | $56.23 | $5,128.61 | $26,302.68 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $489.78 / $5,754.40 / $20,417.38
| Professional | | $489.78 | $5,754.40 | $20,417.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,235.94 / $6,918.31 / $33,884.42
| Facility | | $3,235.94 | $6,918.31 | $33,884.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $588.84 / $8,128.31 / $19,054.61
| Professional | | $588.84 | $8,128.31 | $19,054.61 |