- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,570.40 / $5,888.44 / $10,964.78
| Facility | | $2,570.40 | $5,888.44 | $10,964.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4,168.69 / $5,248.07 / $10,232.93
| Professional | | $4,168.69 | $5,248.07 | $10,232.93 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,466.84 / $8,317.64 / $16,595.87
| Facility | | $4,466.84 | $8,317.64 | $16,595.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,801.89 / $4,466.84 / $8,912.51
| Professional | | $3,801.89 | $4,466.84 | $8,912.51 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,606.93 / $6,606.93 / $37,153.52
| Facility | | $6,606.93 | $6,606.93 | $37,153.52 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6,606.93 / $6,606.93 / $6,606.93
| Professional | | $6,606.93 | $6,606.93 | $6,606.93 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $34.67 / $7,762.47 / $50,118.72
| Facility | | $34.67 | $7,762.47 | $50,118.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,467.37 / $6,606.93 / $16,982.44
| Professional | | $3,467.37 | $6,606.93 | $16,982.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,677.35 / $5,754.40 / $16,982.44
| Facility | | $4,677.35 | $5,754.40 | $16,982.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5,248.07 / $6,760.83 / $10,232.93
| Professional | | $5,248.07 | $6,760.83 | $10,232.93 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,365.16 / $4,365.16 / $4,365.16
| Facility | | $4,365.16 | $4,365.16 | $4,365.16 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,801.89 / $6,165.95 / $9,772.37
| Professional | | $3,801.89 | $6,165.95 | $9,772.37 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,786.30 / $50,118.72 / $75,857.76
| Facility | | $4,786.30 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5,754.40 / $6,760.83 / $12,302.69
| Professional | | $5,754.40 | $6,760.83 | $12,302.69 |
- 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
- $4,677.35 / $7,762.47 / $38,904.51
| Professional | | $4,677.35 | $7,762.47 | $38,904.51 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,801.89 / $5,495.41 / $16,595.87
| Facility | | $3,801.89 | $5,495.41 | $16,595.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,801.89 / $5,888.44 / $11,748.98
| Professional | | $3,801.89 | $5,888.44 | $11,748.98 |