- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,570.40 / $5,888.44 / $10,964.78
| Facility | | $2,570.40 | $5,888.44 | $10,964.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,981.07 / $4,897.79 / $9,549.93
| Professional | | $3,981.07 | $4,897.79 | $9,549.93 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,073.80 / $7,762.47 / $13,803.84
| Facility | | $4,073.80 | $7,762.47 | $13,803.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,630.78 / $4,265.80 / $9,120.11
| Professional | | $3,630.78 | $4,265.80 | $9,120.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,165.95 / $6,165.95 / $37,153.52
| Facility | | $6,165.95 | $6,165.95 | $37,153.52 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6,165.95 / $6,165.95 / $6,165.95
| Professional | | $6,165.95 | $6,165.95 | $6,165.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $34.67 / $7,413.10 / $50,118.72
| Facility | | $34.67 | $7,413.10 | $50,118.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,454.71 / $6,165.95 / $16,218.10
| Professional | | $2,454.71 | $6,165.95 | $16,218.10 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,467.37 / $5,248.07 / $14,125.38
| Facility | | $3,467.37 | $5,248.07 | $14,125.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4,677.35 / $6,165.95 / $9,549.93
| Professional | | $4,677.35 | $6,165.95 | $9,549.93 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,981.07 / $3,981.07 / $3,981.07
| Facility | | $3,981.07 | $3,981.07 | $3,981.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,235.94 / $5,754.40 / $9,120.11
| Professional | | $3,235.94 | $5,754.40 | $9,120.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,073.80 / $50,118.72 / $75,857.76
| Facility | | $4,073.80 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $398.11 / $5,888.44 / $10,471.29
| Professional | | $398.11 | $5,888.44 | $10,471.29 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,479.11 / $3,981.07 / $9,332.54
| Facility | | $1,479.11 | $3,981.07 | $9,332.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4,265.80 / $6,760.83 / $28,840.32
| Professional | | $4,265.80 | $6,760.83 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,467.37 / $5,128.61 / $10,715.19
| Facility | | $3,467.37 | $5,128.61 | $10,715.19 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,467.37 / $5,370.32 / $10,715.19
| Professional | | $3,467.37 | $5,370.32 | $10,715.19 |