- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,011.87 / $8,128.31 / $21,877.62
| Facility | | $5,011.87 | $8,128.31 | $21,877.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,388.44 / $4,265.80 / $8,128.31
| Professional | | $3,388.44 | $4,265.80 | $8,128.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5,754.40 / $7,079.46 / $9,332.54
| Professional | | $5,754.40 | $7,079.46 | $9,332.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $501.19 / $707.95 / $6,309.57
| Facility | | $501.19 | $707.95 | $6,309.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,951.21 / $5,754.40 / $10,964.78
| Professional | | $2,951.21 | $5,754.40 | $10,964.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,981.07 / $6,025.60 / $9,332.54
| Facility | | $3,981.07 | $6,025.60 | $9,332.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,548.13 / $5,888.44 / $9,120.11
| Professional | | $3,548.13 | $5,888.44 | $9,120.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $229.09
| Professional | | $32.36 | $33.11 | $229.09 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,011.87 / $7,079.46 / $7,413.10
| Facility | | $5,011.87 | $7,079.46 | $7,413.10 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,011.87 / $5,011.87 / $5,011.87
| Facility | | $5,011.87 | $5,011.87 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5,011.87 / $7,244.36 / $10,471.29
| Professional | | $5,011.87 | $7,244.36 | $10,471.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5,754.40 / $7,079.46 / $9,120.11
| Professional | | $5,754.40 | $7,079.46 | $9,120.11 |
- 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
- $3,890.45 / $5,495.41 / $9,549.93
| Professional | | $3,890.45 | $5,495.41 | $9,549.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,388.44 / $3,890.45 / $6,918.31
| Professional | | $3,388.44 | $3,890.45 | $6,918.31 |