- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,570.88 / $6,165.95 / $20,892.96
| Facility | | $4,570.88 | $6,165.95 | $20,892.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,187.76 / $2,754.23 / $6,309.57
| Professional | | $2,187.76 | $2,754.23 | $6,309.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,548.13 / $4,677.35 / $6,165.95
| Professional | | $3,548.13 | $4,677.35 | $6,165.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $501.19 / $870.96 / $4,168.69
| Facility | | $501.19 | $870.96 | $4,168.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,905.46 / $3,801.89 / $7,413.10
| Professional | | $1,905.46 | $3,801.89 | $7,413.10 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,344.23 / $4,073.80 / $6,165.95
| Facility | | $2,344.23 | $4,073.80 | $6,165.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,290.87 / $3,890.45 / $6,165.95
| Professional | | $2,290.87 | $3,890.45 | $6,165.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $1,071.52
| Professional | | $32.36 | $33.11 | $1,071.52 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,090.30 / $4,677.35 / $4,897.79
| Facility | | $3,090.30 | $4,677.35 | $4,897.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,311.31 / $3,311.31 / $3,388.44
| Facility | | $3,311.31 | $3,311.31 | $3,388.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,388.44 / $4,897.79 / $7,079.46
| Professional | | $3,388.44 | $4,897.79 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,715.35 / $4,786.30 / $6,025.60
| Professional | | $3,715.35 | $4,786.30 | $6,025.60 |
- 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
- $2,454.71 / $3,467.37 / $6,309.57
| Professional | | $2,454.71 | $3,467.37 | $6,309.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,238.72 / $2,570.40 / $4,570.88
| Professional | | $2,238.72 | $2,570.40 | $4,570.88 |