- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,344.23 / $7,943.28 / $14,454.40
| Facility | | $2,344.23 | $7,943.28 | $14,454.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,148.15 / $1,380.38 / $2,398.83
| Professional | | $1,148.15 | $1,380.38 | $2,398.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,025.60 / $7,762.47 / $15,135.61
| Facility | | $6,025.60 | $7,762.47 | $15,135.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,122.02 / $1,905.46 / $2,511.89
| Professional | | $1,122.02 | $1,905.46 | $2,511.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $676.08 / $2,454.71 / $4,073.80
| Professional | | $676.08 | $2,454.71 | $4,073.80 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,148.15 / $1,905.46 / $3,715.35
| Facility | | $1,148.15 | $1,905.46 | $3,715.35 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,445.44 / $2,398.83 / $9,332.54
| Professional | | $1,445.44 | $2,398.83 | $9,332.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,398.83 / $2,951.21 / $4,073.80
| Professional | | $2,398.83 | $2,951.21 | $4,073.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,187.76 / $2,454.71 / $4,073.80
| Professional | | $2,187.76 | $2,454.71 | $4,073.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $1,905.46 / $3,311.31
| Professional | | $7.08 | $1,905.46 | $3,311.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,235.94 / $4,466.84 / $8,128.31
| Facility | | $3,235.94 | $4,466.84 | $8,128.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,445.44 / $1,949.84 / $3,162.28
| Professional | | $1,445.44 | $1,949.84 | $3,162.28 |