- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,513.56 / $3,630.78 / $9,549.93
| Facility | | $1,513.56 | $3,630.78 | $9,549.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,318.26 / $1,584.89 / $2,691.53
| Professional | | $1,318.26 | $1,584.89 | $2,691.53 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,918.31 / $10,964.78 / $14,791.08
| Facility | | $6,918.31 | $10,964.78 | $14,791.08 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,348.96 / $1,778.28 / $2,570.40
| Professional | | $1,348.96 | $1,778.28 | $2,570.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,445.44 / $1,819.70 / $2,454.71
| Professional | | $1,445.44 | $1,819.70 | $2,454.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,230.27 / $1,698.24 / $2,951.21
| Professional | | $1,230.27 | $1,698.24 | $2,951.21 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,258.93 / $1,513.56 / $3,981.07
| Professional | | $1,258.93 | $1,513.56 | $3,981.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,621.81 / $2,041.74 / $3,235.94
| Professional | | $1,621.81 | $2,041.74 | $3,235.94 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,380.38 / $1,905.46 / $2,884.03
| Facility | | $1,380.38 | $1,905.46 | $2,884.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,202.26 / $1,819.70 / $6,165.95
| Facility | | $1,202.26 | $1,819.70 | $6,165.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,202.26 / $1,819.70 / $6,165.95
| Professional | | $1,202.26 | $1,819.70 | $6,165.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,621.81 / $3,311.31 / $6,309.57
| Facility | | $1,621.81 | $3,311.31 | $6,309.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,148.15 / $1,621.81 / $2,754.23
| Professional | | $1,148.15 | $1,621.81 | $2,754.23 |