- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,202.26 / $3,630.78 / $9,549.93
| Facility | | $1,202.26 | $3,630.78 | $9,549.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,071.52 / $1,230.27 / $2,137.96
| Professional | | $1,071.52 | $1,230.27 | $2,137.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8,709.64 / $16,218.10 / $21,877.62
| Facility | | $8,709.64 | $16,218.10 | $21,877.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,071.52 / $1,412.54 / $2,041.74
| Professional | | $1,071.52 | $1,412.54 | $2,041.74 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,288.25 / $8,709.64 / $14,454.40
| Professional | | $1,288.25 | $8,709.64 | $14,454.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,071.52 / $1,445.44 / $2,290.87
| Professional | | $1,071.52 | $1,445.44 | $2,290.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,000.00 / $1,174.90 / $3,019.95
| Professional | | $1,000.00 | $1,174.90 | $3,019.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,445.44 / $1,819.70 / $2,630.27
| Professional | | $1,445.44 | $1,819.70 | $2,630.27 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,122.02 / $1,659.59 / $2,344.23
| Facility | | $1,122.02 | $1,659.59 | $2,344.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,047.13 / $1,548.82 / $5,370.32
| Facility | | $1,047.13 | $1,548.82 | $5,370.32 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,047.13 / $1,548.82 / $5,370.32
| Professional | | $1,047.13 | $1,548.82 | $5,370.32 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,584.89 / $3,311.31 / $6,309.57
| Facility | | $1,584.89 | $3,311.31 | $6,309.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $977.24 / $1,445.44 / $2,344.23
| Professional | | $977.24 | $1,445.44 | $2,344.23 |