- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,715.35 / $10,471.29 / $23,988.33
| Facility | | $3,715.35 | $10,471.29 | $23,988.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $331.13 / $1,737.80 / $3,890.45
| Professional | | $331.13 | $1,737.80 | $3,890.45 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,025.60 / $10,471.29 / $17,782.79
| Facility | | $6,025.60 | $10,471.29 | $17,782.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $575.44 / $3,630.78 / $7,585.78
| Professional | | $575.44 | $3,630.78 | $7,585.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $83.18 / $4,365.16 / $9,120.11
| Facility | | $83.18 | $4,365.16 | $9,120.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $363.08 / $1,621.81 / $5,128.61
| Professional | | $363.08 | $1,621.81 | $5,128.61 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,365.16 / $5,128.61 / $6,456.54
| Facility | | $4,365.16 | $5,128.61 | $6,456.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $380.19 / $1,148.15 / $4,073.80
| Professional | | $380.19 | $1,148.15 | $4,073.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $316.23 / $1,949.84 / $3,019.95
| Professional | | $316.23 | $1,949.84 | $3,019.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $295.12 / $1,698.24 / $3,388.44
| Professional | | $295.12 | $1,698.24 | $3,388.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $54.95 / $56.23 / $20,417.38
| Facility | | $54.95 | $56.23 | $20,417.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12,302.69 / $14,454.40 / $14,454.40
| Professional | | $12,302.69 | $14,454.40 | $14,454.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,445.44 / $1,445.44 / $2,454.71
| Professional | | $1,445.44 | $1,445.44 | $2,454.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $363.08 / $1,862.09 / $3,467.37
| Facility | | $363.08 | $1,862.09 | $3,467.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $371.54 / $1,071.52 / $4,466.84
| Professional | | $371.54 | $1,071.52 | $4,466.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,122.02 / $1,122.02 / $6,918.31
| Professional | | $1,122.02 | $1,122.02 | $6,918.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $288.40 / $1,949.84 / $3,311.31
| Professional | | $288.40 | $1,949.84 | $3,311.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7,762.47 / $13,803.84 / $28,840.32
| Facility | | $7,762.47 | $13,803.84 | $28,840.32 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $331.13 / $1,621.81 / $4,265.80
| Professional | | $331.13 | $1,621.81 | $4,265.80 |