- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,570.40 / $5,370.32 / $10,964.78
| Facility | | $2,570.40 | $5,370.32 | $10,964.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,715.35 / $4,570.88 / $8,912.51
| Professional | | $3,715.35 | $4,570.88 | $8,912.51 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,388.44 / $5,495.41 / $12,882.50
| Facility | | $3,388.44 | $5,495.41 | $12,882.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,388.44 / $4,073.80 / $8,128.31
| Professional | | $3,388.44 | $4,073.80 | $8,128.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,888.44 / $5,888.44 / $37,153.52
| Facility | | $5,888.44 | $5,888.44 | $37,153.52 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5,888.44 / $5,888.44 / $5,888.44
| Professional | | $5,888.44 | $5,888.44 | $5,888.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $34.67 / $7,244.36 / $50,118.72
| Facility | | $34.67 | $7,244.36 | $50,118.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,754.23 / $5,754.40 / $15,488.17
| Professional | | $2,754.23 | $5,754.40 | $15,488.17 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,890.45 / $5,128.61 / $15,488.17
| Facility | | $3,890.45 | $5,128.61 | $15,488.17 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4,466.84 / $5,888.44 / $9,332.54
| Professional | | $4,466.84 | $5,888.44 | $9,332.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,890.45 / $3,890.45 / $3,890.45
| Facility | | $3,890.45 | $3,890.45 | $3,890.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,019.95 / $5,495.41 / $8,709.64
| Professional | | $3,019.95 | $5,495.41 | $8,709.64 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,715.35 / $50,118.72 / $75,857.76
| Facility | | $3,715.35 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $398.11 / $5,623.41 / $9,332.54
| Professional | | $398.11 | $5,623.41 | $9,332.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,479.11 / $3,981.07 / $9,332.54
| Facility | | $1,479.11 | $3,981.07 | $9,332.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4,073.80 / $6,606.93 / $32,359.37
| Professional | | $4,073.80 | $6,606.93 | $32,359.37 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,388.44 / $5,011.87 / $14,454.40
| Facility | | $3,388.44 | $5,011.87 | $14,454.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,388.44 / $5,011.87 / $10,471.29
| Professional | | $3,388.44 | $5,011.87 | $10,471.29 |