- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $724.44 / $6,025.60 / $12,302.69
| Facility | | $724.44 | $6,025.60 | $12,302.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $512.86 / $1,202.26 / $14,125.38
| Professional | | $512.86 | $1,202.26 | $14,125.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,011.87 / $10,964.78 / $19,498.45
| Facility | | $5,011.87 | $10,964.78 | $19,498.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5,888.44 / $7,585.78 / $20,417.38
| Professional | | $5,888.44 | $7,585.78 | $20,417.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $660.69 / $1,995.26 / $13,489.63
| Facility | | $660.69 | $1,995.26 | $13,489.63 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $660.69 / $660.69 / $10,964.78
| Professional | | $660.69 | $660.69 | $10,964.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $34.67 / $5,754.40 / $53,703.18
| Facility | | $34.67 | $5,754.40 | $53,703.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $524.81 / $2,691.53 / $21,379.62
| Professional | | $524.81 | $2,691.53 | $21,379.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $489.78 / $645.65 / $1,584.89
| Facility | | $489.78 | $645.65 | $1,584.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6,918.31 / $10,471.29 / $14,791.08
| Professional | | $6,918.31 | $10,471.29 | $14,791.08 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5,623.41 / $7,762.47 / $12,589.25
| Professional | | $5,623.41 | $7,762.47 | $12,589.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,888.44 / $19,952.62 / $34,673.69
| Facility | | $5,888.44 | $19,952.62 | $34,673.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $575.44 / $575.44 / $1,122.02
| Professional | | $575.44 | $575.44 | $1,122.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $588.84 / $50,118.72 / $75,857.76
| Facility | | $588.84 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8,128.31 / $10,232.93 / $11,481.54
| Professional | | $8,128.31 | $10,232.93 | $11,481.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,691.53 / $7,762.47 / $25,703.96
| Facility | | $2,691.53 | $7,762.47 | $25,703.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $457.09 / $6,606.93 / $15,848.93
| Professional | | $457.09 | $6,606.93 | $15,848.93 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $380.19 / $588.84 / $1,023.29
| Facility | | $380.19 | $588.84 | $1,023.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $891.25 / $6,606.93 / $11,748.98
| Professional | | $891.25 | $6,606.93 | $11,748.98 |