- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,230.27 / $4,365.16 / $10,232.93
| Facility | | $1,230.27 | $4,365.16 | $10,232.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,949.84 / $2,238.72 / $3,388.44
| Professional | | $1,949.84 | $2,238.72 | $3,388.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,290.87 / $3,715.35 / $8,511.38
| Facility | | $2,290.87 | $3,715.35 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,698.24 / $2,089.30 / $3,235.94
| Professional | | $1,698.24 | $2,089.30 | $3,235.94 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,905.46 / $1,905.46 / $1,995.26
| Facility | | $1,905.46 | $1,905.46 | $1,995.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $537.03 / $891.25 / $3,548.13
| Facility | | $537.03 | $891.25 | $3,548.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,584.89 / $2,691.53 / $4,570.88
| Professional | | $1,584.89 | $2,691.53 | $4,570.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,818.38 / $10,232.93 / $13,182.57
| Facility | | $2,818.38 | $10,232.93 | $13,182.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15,135.61 / $17,378.01 / $17,378.01
| Professional | | $15,135.61 | $17,378.01 | $17,378.01 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,949.84 / $2,754.23 / $5,248.07
| Facility | | $1,949.84 | $2,754.23 | $5,248.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,041.74 / $2,454.71 / $4,073.80
| Professional | | $2,041.74 | $2,454.71 | $4,073.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $1,778.28
| Professional | | $32.36 | $33.11 | $1,778.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $4,365.16 / $6,918.31
| Professional | | $7.08 | $4,365.16 | $6,918.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,995.26 / $2,691.53 / $4,786.30
| Facility | | $1,995.26 | $2,691.53 | $4,786.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $912.01 / $2,754.23 / $4,897.79
| Professional | | $912.01 | $2,754.23 | $4,897.79 |
- 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
- $1,778.28 / $2,398.83 / $3,630.78
| Professional | | $1,778.28 | $2,398.83 | $3,630.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,621.81 / $1,995.26 / $2,344.23
| Professional | | $1,621.81 | $1,995.26 | $2,344.23 |