- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,071.52 / $1,995.26 / $14,454.40
| Facility | | $1,071.52 | $1,995.26 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,011.87 / $8,317.64 / $13,803.84
| Facility | | $5,011.87 | $8,317.64 | $13,803.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,511.89 / $2,951.21 / $4,677.35
| Facility | | $2,511.89 | $2,951.21 | $4,677.35 |
- Facility/Professional
- Facility
- Modifier
- AS
- Typical Low / Median / Typical High
- $169.82 / $169.82 / $169.82
| Facility | AS | $169.82 | $169.82 | $169.82 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $954.99 / $1,348.96 / $8,912.51
| Facility | | $954.99 | $1,348.96 | $8,912.51 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $954.99 / $1,348.96 / $6,309.57
| Facility | | $954.99 | $1,348.96 | $6,309.57 |
- Facility/Professional
- Facility
- Modifier
- AS
- Typical Low / Median / Typical High
- $457.09 / $457.09 / $457.09
| Facility | AS | $457.09 | $457.09 | $457.09 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,445.44 / $1,445.44 / $1,995.26
| Facility | | $1,445.44 | $1,445.44 | $1,995.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,202.26 / $2,137.96 / $3,311.31
| Professional | | $1,202.26 | $2,137.96 | $3,311.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,698.24 / $7,943.28 / $7,943.28
| Facility | | $1,698.24 | $7,943.28 | $7,943.28 |
- Facility/Professional
- Facility
- Modifier
- AS
- Typical Low / Median / Typical High
- $169.82 / $251.19 / $794.33
| Facility | AS | $169.82 | $251.19 | $794.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,548.13 / $3,548.13 / $3,548.13
| Professional | | $3,548.13 | $3,548.13 | $3,548.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,995.26 / $6,760.83 / $19,498.45
| Facility | | $1,995.26 | $6,760.83 | $19,498.45 |