- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $630.96 / $5,888.44 / $22,908.68
| Facility | | $630.96 | $5,888.44 | $22,908.68 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $338.84 / $1,584.89 / $3,235.94
| Professional | | $338.84 | $1,584.89 | $3,235.94 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11,481.54 / $15,135.61 / $30,902.95
| Facility | | $11,481.54 | $15,135.61 | $30,902.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $549.54 / $1,047.13 / $4,570.88
| Professional | | $549.54 | $1,047.13 | $4,570.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8,128.31 / $8,128.31 / $8,128.31
| Facility | | $8,128.31 | $8,128.31 | $8,128.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $478.63 / $1,047.13 / $5,370.32
| Professional | | $478.63 | $1,047.13 | $5,370.32 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $575.44 / $3,801.89 / $23,442.29
| Facility | | $575.44 | $3,801.89 | $23,442.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $616.60 / $2,570.40 / $5,495.41
| Professional | | $616.60 | $2,570.40 | $5,495.41 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $208.93
| Professional | | $32.36 | $33.11 | $208.93 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,454.71 / $3,388.44 / $3,890.45
| Facility | | $2,454.71 | $3,388.44 | $3,890.45 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,454.71 / $2,570.40 / $2,570.40
| Facility | | $2,454.71 | $2,570.40 | $2,570.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $467.74 / $2,454.71 / $4,365.16
| Professional | | $467.74 | $2,454.71 | $4,365.16 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11,220.18 / $15,848.93 / $30,902.95
| Facility | | $11,220.18 | $15,848.93 | $30,902.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $549.54 / $1,047.13 / $4,168.69
| Professional | | $549.54 | $1,047.13 | $4,168.69 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,248.07 / $18,197.01 / $32,359.37
| Facility | | $5,248.07 | $18,197.01 | $32,359.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $478.63 / $1,737.80 / $4,365.16
| Professional | | $478.63 | $1,737.80 | $4,365.16 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $346.74 / $602.56 / $3,981.07
| Professional | | $346.74 | $602.56 | $3,981.07 |