- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,786.30 / $7,943.28 / $20,892.96
| Facility | | $4,786.30 | $7,943.28 | $20,892.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,235.94 / $4,073.80 / $8,709.64
| Professional | | $3,235.94 | $4,073.80 | $8,709.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5,248.07 / $6,918.31 / $8,912.51
| Professional | | $5,248.07 | $6,918.31 | $8,912.51 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $501.19 / $870.96 / $6,165.95
| Facility | | $501.19 | $870.96 | $6,165.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,691.53 / $5,495.41 / $10,471.29
| Professional | | $2,691.53 | $5,495.41 | $10,471.29 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,467.37 / $6,025.60 / $9,120.11
| Facility | | $3,467.37 | $6,025.60 | $9,120.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,388.44 / $5,623.41 / $9,120.11
| Professional | | $3,388.44 | $5,623.41 | $9,120.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $1,548.82
| Professional | | $32.36 | $33.11 | $1,548.82 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,073.80 / $6,760.83 / $7,079.46
| Facility | | $4,073.80 | $6,760.83 | $7,079.46 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,786.30 / $4,786.30 / $4,897.79
| Facility | | $4,786.30 | $4,786.30 | $4,897.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4,897.79 / $7,079.46 / $10,232.93
| Professional | | $4,897.79 | $7,079.46 | $10,232.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5,370.32 / $6,918.31 / $8,912.51
| Professional | | $5,370.32 | $6,918.31 | $8,912.51 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $691.83 / $1,258.93 / $3,715.35
| Facility | | $691.83 | $1,258.93 | $3,715.35 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,388.44 / $5,128.61 / $9,120.11
| Professional | | $3,388.44 | $5,128.61 | $9,120.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,311.31 / $3,801.89 / $6,606.93
| Professional | | $3,311.31 | $3,801.89 | $6,606.93 |