- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,677.35 / $6,456.54 / $20,892.96
| Facility | | $4,677.35 | $6,456.54 | $20,892.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,344.23 / $3,019.95 / $6,025.60
| Professional | | $2,344.23 | $3,019.95 | $6,025.60 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,890.45 / $5,128.61 / $6,760.83
| Professional | | $3,890.45 | $5,128.61 | $6,760.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $501.19 / $870.96 / $4,570.88
| Facility | | $501.19 | $870.96 | $4,570.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,041.74 / $4,168.69 / $7,943.28
| Professional | | $2,041.74 | $4,168.69 | $7,943.28 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,570.40 / $4,365.16 / $6,760.83
| Facility | | $2,570.40 | $4,365.16 | $6,760.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,511.89 / $4,168.69 / $6,606.93
| Professional | | $2,511.89 | $4,168.69 | $6,606.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $1,174.90
| Professional | | $32.36 | $33.11 | $1,174.90 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,311.31 / $5,011.87 / $5,248.07
| Facility | | $3,311.31 | $5,011.87 | $5,248.07 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,630.78 / $3,630.78 / $3,715.35
| Facility | | $3,630.78 | $3,630.78 | $3,715.35 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,715.35 / $5,248.07 / $7,762.47
| Professional | | $3,715.35 | $5,248.07 | $7,762.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,981.07 / $5,248.07 / $6,606.93
| Professional | | $3,981.07 | $5,248.07 | $6,606.93 |
- 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
- $2,691.53 / $3,801.89 / $6,918.31
| Professional | | $2,691.53 | $3,801.89 | $6,918.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,454.71 / $2,818.38 / $5,011.87
| Professional | | $2,454.71 | $2,818.38 | $5,011.87 |