- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,778.28 / $5,888.44 / $16,595.87
| Facility | | $1,778.28 | $5,888.44 | $16,595.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $371.54 / $912.01 / $3,548.13
| Professional | | $371.54 | $912.01 | $3,548.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,630.78 / $6,165.95 / $13,489.63
| Facility | | $3,630.78 | $6,165.95 | $13,489.63 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $501.19 / $3,467.37 / $6,025.60
| Professional | | $501.19 | $3,467.37 | $6,025.60 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $85.11 / $4,786.30 / $9,120.11
| Facility | | $85.11 | $4,786.30 | $9,120.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,089.30 / $3,890.45 / $6,918.31
| Professional | | $2,089.30 | $3,890.45 | $6,918.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $660.69 / $1,047.13 / $1,862.09
| Facility | | $660.69 | $1,047.13 | $1,862.09 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $398.11 / $851.14 / $3,890.45
| Professional | | $398.11 | $851.14 | $3,890.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $281.84 / $501.19 / $1,479.11
| Professional | | $281.84 | $501.19 | $1,479.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $380.19 / $891.25 / $1,819.70
| Professional | | $380.19 | $891.25 | $1,819.70 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $54.95 / $56.23 / $9,332.54
| Facility | | $54.95 | $56.23 | $9,332.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14,454.40 / $14,454.40 / $15,488.17
| Professional | | $14,454.40 | $14,454.40 | $15,488.17 |
- 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
- $398.11 / $912.01 / $3,388.44
| Facility | | $398.11 | $912.01 | $3,388.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $398.11 / $912.01 / $3,801.89
| Professional | | $398.11 | $912.01 | $3,801.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,230.27 / $1,230.27 / $3,235.94
| Professional | | $1,230.27 | $1,230.27 | $3,235.94 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $371.54 / $426.58 / $1,148.15
| Professional | | $371.54 | $426.58 | $1,148.15 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,162.28 / $7,079.46 / $14,454.40
| Facility | | $3,162.28 | $7,079.46 | $14,454.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $338.84 / $812.83 / $3,467.37
| Professional | | $338.84 | $812.83 | $3,467.37 |