- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,365.16 / $7,244.36 / $17,378.01
| Facility | | $4,365.16 | $7,244.36 | $17,378.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4,073.80 / $4,786.30 / $8,912.51
| Professional | | $4,073.80 | $4,786.30 | $8,912.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4,265.80 / $5,754.40 / $12,589.25
| Professional | | $4,265.80 | $5,754.40 | $12,589.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $323.59 / $512.86 / $35,481.34
| Facility | | $323.59 | $512.86 | $35,481.34 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,454.71 / $5,623.41 / $10,964.78
| Professional | | $2,454.71 | $5,623.41 | $10,964.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5,888.44 / $5,888.44 / $5,888.44
| Professional | | $5,888.44 | $5,888.44 | $5,888.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,162.28 / $5,128.61 / $8,511.38
| Facility | | $3,162.28 | $5,128.61 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,951.21 / $2,951.21 / $11,748.98
| Professional | | $2,951.21 | $2,951.21 | $11,748.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,570.40 / $2,630.27 / $6,760.83
| Professional | | $2,570.40 | $2,630.27 | $6,760.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $323.59 / $2,570.40 / $6,309.57
| Facility | | $323.59 | $2,570.40 | $6,309.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,388.44 / $4,677.35 / $8,912.51
| Professional | | $3,388.44 | $4,677.35 | $8,912.51 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $56.23 / $26,915.35 / $26,915.35
| Facility | | $56.23 | $26,915.35 | $26,915.35 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $30,902.95 / $30,902.95 / $37,153.52
| Professional | | $30,902.95 | $30,902.95 | $37,153.52 |