- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,819.70 / $5,248.07 / $12,022.64
| Facility | | $1,819.70 | $5,248.07 | $12,022.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,318.26 / $1,584.89 / $3,311.31
| Professional | | $1,318.26 | $1,584.89 | $3,311.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,388.44 / $5,623.41 / $12,882.50
| Facility | | $3,388.44 | $5,623.41 | $12,882.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,202.26 / $1,412.54 / $2,818.38
| Professional | | $1,202.26 | $1,412.54 | $2,818.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,089.30 / $2,089.30 / $37,153.52
| Facility | | $2,089.30 | $2,089.30 | $37,153.52 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,089.30 / $2,089.30 / $2,089.30
| Professional | | $2,089.30 | $2,089.30 | $2,089.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $34.67 / $2,511.89 / $50,118.72
| Facility | | $34.67 | $2,511.89 | $50,118.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,096.48 / $2,089.30 / $5,495.41
| Professional | | $1,096.48 | $2,089.30 | $5,495.41 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,479.11 / $1,819.70 / $5,370.32
| Facility | | $1,479.11 | $1,819.70 | $5,370.32 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,584.89 / $2,089.30 / $3,235.94
| Professional | | $1,584.89 | $2,089.30 | $3,235.94 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,380.38 / $1,380.38 / $1,380.38
| Facility | | $1,380.38 | $1,380.38 | $1,380.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,174.90 / $1,949.84 / $3,090.30
| Professional | | $1,174.90 | $1,949.84 | $3,090.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,445.44 / $50,118.72 / $75,857.76
| Facility | | $1,445.44 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $398.11 / $1,995.26 / $3,235.94
| Professional | | $398.11 | $1,995.26 | $3,235.94 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,445.44 / $3,981.07 / $8,912.51
| Facility | | $1,445.44 | $3,981.07 | $8,912.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,445.44 / $2,398.83 / $12,302.69
| Professional | | $1,445.44 | $2,398.83 | $12,302.69 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,202.26 / $1,737.80 / $5,248.07
| Facility | | $1,202.26 | $1,737.80 | $5,248.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,202.26 / $1,737.80 / $3,715.35
| Professional | | $1,202.26 | $1,737.80 | $3,715.35 |