- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,778.28 / $8,912.51 / $20,892.96
| Facility | | $1,778.28 | $8,912.51 | $20,892.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $851.14 / $1,096.48 / $2,754.23
| Professional | | $851.14 | $1,096.48 | $2,754.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7,244.36 / $9,120.11 / $18,620.87
| Facility | | $7,244.36 | $9,120.11 | $18,620.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,380.38 / $1,819.70 / $2,398.83
| Professional | | $1,380.38 | $1,819.70 | $2,398.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $501.19 / $707.95 / $1,621.81
| Facility | | $501.19 | $707.95 | $1,621.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $741.31 / $1,479.11 / $2,884.03
| Professional | | $741.31 | $1,479.11 | $2,884.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,023.29 / $1,949.84 / $4,168.69
| Facility | | $1,023.29 | $1,949.84 | $4,168.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $912.01 / $1,698.24 / $2,754.23
| Professional | | $912.01 | $1,698.24 | $2,754.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $549.54
| Professional | | $32.36 | $33.11 | $549.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,348.96 / $1,862.09 / $1,862.09
| Facility | | $1,348.96 | $1,862.09 | $1,862.09 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,288.25 / $1,288.25 / $1,318.26
| Facility | | $1,288.25 | $1,288.25 | $1,318.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,318.26 / $1,905.46 / $2,754.23
| Professional | | $1,318.26 | $1,905.46 | $2,754.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7,079.46 / $9,549.93 / $18,620.87
| Facility | | $7,079.46 | $9,549.93 | $18,620.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,445.44 / $1,862.09 / $2,398.83
| Professional | | $1,445.44 | $1,862.09 | $2,398.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,137.96 / $10,232.93 / $19,952.62
| Facility | | $2,137.96 | $10,232.93 | $19,952.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $977.24 / $1,318.26 / $2,454.71
| Professional | | $977.24 | $1,318.26 | $2,454.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $891.25 / $1,047.13 / $1,862.09
| Professional | | $891.25 | $1,047.13 | $1,862.09 |