- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,168.69 / $6,606.93 / $15,848.93
| Facility | | $4,168.69 | $6,606.93 | $15,848.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,890.45 / $4,677.35 / $8,511.38
| Professional | | $3,890.45 | $4,677.35 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4,265.80 / $5,248.07 / $12,022.64
| Professional | | $4,265.80 | $5,248.07 | $12,022.64 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $323.59 / $512.86 / $35,481.34
| Facility | | $323.59 | $512.86 | $35,481.34 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4,073.80 / $5,888.44 / $10,471.29
| Professional | | $4,073.80 | $5,888.44 | $10,471.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6,456.54 / $6,456.54 / $6,456.54
| Professional | | $6,456.54 | $6,456.54 | $6,456.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,981.07 / $5,128.61 / $7,943.28
| Facility | | $3,981.07 | $5,128.61 | $7,943.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4,265.80 / $4,265.80 / $11,481.54
| Professional | | $4,265.80 | $4,265.80 | $11,481.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,981.07 / $4,168.69 / $4,168.69
| Professional | | $3,981.07 | $4,168.69 | $4,168.69 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $323.59 / $2,570.40 / $6,309.57
| Facility | | $323.59 | $2,570.40 | $6,309.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,467.37 / $4,677.35 / $8,317.64
| Professional | | $3,467.37 | $4,677.35 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $56.23 / $26,302.68 / $26,302.68
| Facility | | $56.23 | $26,302.68 | $26,302.68 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $30,199.52 / $30,199.52 / $37,153.52
| Professional | | $30,199.52 | $30,199.52 | $37,153.52 |