- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,202.26 / $4,365.16 / $10,232.93
| Facility | | $1,202.26 | $4,365.16 | $10,232.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,951.21 / $3,388.44 / $4,897.79
| Professional | | $2,951.21 | $3,388.44 | $4,897.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,884.03 / $3,467.37 / $4,897.79
| Professional | | $2,884.03 | $3,467.37 | $4,897.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,884.03 / $2,884.03 / $3,162.28
| Facility | | $2,884.03 | $2,884.03 | $3,162.28 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $537.03 / $891.25 / $5,370.32
| Facility | | $537.03 | $891.25 | $5,370.32 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,454.71 / $4,168.69 / $6,606.93
| Professional | | $2,454.71 | $4,168.69 | $6,606.93 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,818.38 / $2,818.38 / $19,498.45
| Facility | | $2,818.38 | $2,818.38 | $19,498.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $22,387.21 / $26,915.35 / $26,915.35
| Professional | | $22,387.21 | $26,915.35 | $26,915.35 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,884.03 / $3,801.89 / $7,244.36
| Facility | | $2,884.03 | $3,801.89 | $7,244.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,951.21 / $3,548.13 / $5,495.41
| Professional | | $2,951.21 | $3,548.13 | $5,495.41 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $2,691.53
| Professional | | $32.36 | $33.11 | $2,691.53 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.14 / $5,623.41 / $7,943.28
| Professional | | $15.14 | $5,623.41 | $7,943.28 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,951.21 / $3,801.89 / $7,079.46
| Facility | | $2,951.21 | $3,801.89 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,621.81 / $4,168.69 / $7,585.78
| Professional | | $1,621.81 | $4,168.69 | $7,585.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $446.68 / $2,290.87 / $8,912.51
| Facility | | $446.68 | $2,290.87 | $8,912.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,691.53 / $3,630.78 / $5,623.41
| Professional | | $2,691.53 | $3,630.78 | $5,623.41 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,398.83 / $3,162.28 / $3,548.13
| Professional | | $2,398.83 | $3,162.28 | $3,548.13 |