- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,905.46 / $5,370.32 / $10,964.78
| Facility | | $1,905.46 | $5,370.32 | $10,964.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $851.14 / $1,148.15 / $1,548.82
| Professional | | $851.14 | $1,148.15 | $1,548.82 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,388.44 / $5,623.41 / $12,882.50
| Facility | | $3,388.44 | $5,623.41 | $12,882.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $691.83 / $812.83 / $1,230.27
| Professional | | $691.83 | $812.83 | $1,230.27 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,548.82 / $1,548.82 / $37,153.52
| Facility | | $1,548.82 | $1,548.82 | $37,153.52 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,548.82 / $1,548.82 / $1,548.82
| Professional | | $1,548.82 | $1,548.82 | $1,548.82 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $34.67 / $1,862.09 / $50,118.72
| Facility | | $34.67 | $1,862.09 | $50,118.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $851.14 / $1,548.82 / $4,570.88
| Professional | | $851.14 | $1,548.82 | $4,570.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,584.89 / $3,019.95 / $5,370.32
| Facility | | $1,584.89 | $3,019.95 | $5,370.32 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,584.89 / $1,995.26 / $3,090.30
| Professional | | $1,584.89 | $1,995.26 | $3,090.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,288.25 / $1,288.25 / $1,288.25
| Facility | | $1,288.25 | $1,288.25 | $1,288.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,023.29 / $1,819.70 / $2,818.38
| Professional | | $1,023.29 | $1,819.70 | $2,818.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $50,118.72 / $53,703.18 / $75,857.76
| Facility | | $50,118.72 | $53,703.18 | $75,857.76 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,412.54 / $3,981.07 / $9,120.11
| Facility | | $1,412.54 | $3,981.07 | $9,120.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,071.52 / $2,137.96 / $26,302.68
| Professional | | $1,071.52 | $2,137.96 | $26,302.68 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,096.48 / $1,513.56 / $2,454.71
| Facility | | $1,096.48 | $1,513.56 | $2,454.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,023.29 / $1,621.81 / $3,162.28
| Professional | | $1,023.29 | $1,621.81 | $3,162.28 |