- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $831.76 / $1,819.70 / $14,454.40
| Facility | | $831.76 | $1,819.70 | $14,454.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $831.76 / $933.25 / $2,290.87
| Professional | | $831.76 | $933.25 | $2,290.87 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9,120.11 / $12,882.50 / $22,387.21
| Facility | | $9,120.11 | $12,882.50 | $22,387.21 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $891.25 / $1,698.24 / $4,073.80
| Professional | | $891.25 | $1,698.24 | $4,073.80 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,290.87 / $2,691.53 / $4,265.80
| Facility | | $2,290.87 | $2,691.53 | $4,265.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,202.26 / $2,818.38 / $3,162.28
| Professional | | $1,202.26 | $2,818.38 | $3,162.28 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $891.25 / $7,244.36 / $13,489.63
| Facility | | $891.25 | $7,244.36 | $13,489.63 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,584.89 / $2,187.76 / $2,754.23
| Professional | | $1,584.89 | $2,187.76 | $2,754.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $891.25 / $2,818.38 / $7,943.28
| Facility | | $891.25 | $2,818.38 | $7,943.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $954.99 / $1,584.89 / $5,128.61
| Professional | | $954.99 | $1,584.89 | $5,128.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $1,230.27
| Professional | | $32.36 | $33.11 | $1,230.27 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,318.26 / $1,318.26 / $1,862.09
| Facility | | $1,318.26 | $1,318.26 | $1,862.09 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,230.27 / $2,238.72 / $3,162.28
| Professional | | $1,230.27 | $2,238.72 | $3,162.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,148.15 / $2,238.72 / $3,801.89
| Professional | | $1,148.15 | $2,238.72 | $3,801.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,290.87 / $8,511.38 / $8,511.38
| Facility | | $2,290.87 | $8,511.38 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,548.82 / $4,365.16 / $12,882.50
| Professional | | $1,548.82 | $4,365.16 | $12,882.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4,677.35 / $4,677.35 / $4,677.35
| Professional | | $4,677.35 | $4,677.35 | $4,677.35 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4,168.69 / $6,165.95 / $6,165.95
| Professional | | $4,168.69 | $6,165.95 | $6,165.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,290.87 / $7,079.46 / $19,498.45
| Facility | | $2,290.87 | $7,079.46 | $19,498.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $891.25 / $1,513.56 / $3,890.45
| Professional | | $891.25 | $1,513.56 | $3,890.45 |