- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,456.54 / $11,481.54 / $20,892.96
| Facility | | $6,456.54 | $11,481.54 | $20,892.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4,365.16 / $5,495.41 / $14,125.38
| Professional | | $4,365.16 | $5,495.41 | $14,125.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7,079.46 / $9,332.54 / $12,302.69
| Professional | | $7,079.46 | $9,332.54 | $12,302.69 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $501.19 / $707.95 / $8,317.64
| Facility | | $501.19 | $707.95 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,890.45 / $7,585.78 / $14,454.40
| Professional | | $3,890.45 | $7,585.78 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,786.30 / $7,943.28 / $12,302.69
| Facility | | $4,786.30 | $7,943.28 | $12,302.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4,570.88 / $7,762.47 / $12,302.69
| Professional | | $4,570.88 | $7,762.47 | $12,302.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $2,137.96
| Professional | | $32.36 | $33.11 | $2,137.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,165.95 / $9,332.54 / $9,772.37
| Facility | | $6,165.95 | $9,332.54 | $9,772.37 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,606.93 / $6,606.93 / $6,760.83
| Facility | | $6,606.93 | $6,606.93 | $6,760.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6,760.83 / $9,549.93 / $14,125.38
| Professional | | $6,760.83 | $9,549.93 | $14,125.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7,413.10 / $9,549.93 / $12,022.64
| Professional | | $7,413.10 | $9,549.93 | $12,022.64 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $691.83 / $1,258.93 / $4,786.30
| Facility | | $691.83 | $1,258.93 | $4,786.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4,897.79 / $6,918.31 / $12,589.25
| Professional | | $4,897.79 | $6,918.31 | $12,589.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4,365.16 / $5,011.87 / $8,912.51
| Professional | | $4,365.16 | $5,011.87 | $8,912.51 |