- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,905.46 / $8,128.31 / $20,892.96
| Facility | | $1,905.46 | $8,128.31 | $20,892.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $870.96 / $1,318.26 / $2,570.40
| Professional | | $870.96 | $1,318.26 | $2,570.40 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12,022.64 / $17,378.01 / $35,481.34
| Facility | | $12,022.64 | $17,378.01 | $35,481.34 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,412.54 / $1,995.26 / $2,630.27
| Professional | | $1,412.54 | $1,995.26 | $2,630.27 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,801.89 / $3,801.89 / $6,309.57
| Facility | | $3,801.89 | $3,801.89 | $6,309.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,202.26 / $1,949.84 / $3,090.30
| Professional | | $1,202.26 | $1,949.84 | $3,090.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,288.25 / $2,398.83 / $16,982.44
| Facility | | $1,288.25 | $2,398.83 | $16,982.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,258.93 / $2,238.72 / $5,128.61
| Professional | | $1,258.93 | $2,238.72 | $5,128.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $64.57
| Professional | | $32.36 | $33.11 | $64.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,174.90 / $1,949.84 / $2,089.30
| Facility | | $1,174.90 | $1,949.84 | $2,089.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,380.38 / $1,380.38 / $1,412.54
| Facility | | $1,380.38 | $1,380.38 | $1,412.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,412.54 / $2,187.76 / $3,019.95
| Professional | | $1,412.54 | $2,187.76 | $3,019.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12,022.64 / $18,197.01 / $35,481.34
| Facility | | $12,022.64 | $18,197.01 | $35,481.34 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,412.54 / $1,995.26 / $2,630.27
| Professional | | $1,412.54 | $1,995.26 | $2,630.27 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,691.53 / $20,417.38 / $38,018.94
| Facility | | $2,691.53 | $20,417.38 | $38,018.94 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,071.52 / $1,548.82 / $2,884.03
| Professional | | $1,071.52 | $1,548.82 | $2,884.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,071.52 / $1,318.26 / $1,995.26
| Professional | | $1,071.52 | $1,318.26 | $1,995.26 |