- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,137.96 / $6,025.60 / $18,620.87
| Facility | | $2,137.96 | $6,025.60 | $18,620.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,071.52 / $1,479.11 / $2,884.03
| Professional | | $1,071.52 | $1,479.11 | $2,884.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9,772.37 / $13,803.84 / $28,183.83
| Facility | | $9,772.37 | $13,803.84 | $28,183.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,548.82 / $2,187.76 / $2,884.03
| Professional | | $1,548.82 | $2,187.76 | $2,884.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,025.60 / $6,025.60 / $6,025.60
| Facility | | $6,025.60 | $6,025.60 | $6,025.60 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,380.38 / $2,137.96 / $3,388.44
| Professional | | $1,380.38 | $2,137.96 | $3,388.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,513.56 / $2,691.53 / $13,182.57
| Facility | | $1,513.56 | $2,691.53 | $13,182.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,445.44 / $2,570.40 / $4,897.79
| Professional | | $1,445.44 | $2,570.40 | $4,897.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $64.57
| Professional | | $32.36 | $33.11 | $64.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,348.96 / $2,238.72 / $2,290.87
| Facility | | $1,348.96 | $2,238.72 | $2,290.87 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,513.56 / $1,513.56 / $1,548.82
| Facility | | $1,513.56 | $1,513.56 | $1,548.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,548.82 / $2,454.71 / $3,388.44
| Professional | | $1,548.82 | $2,454.71 | $3,388.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9,549.93 / $14,454.40 / $28,183.83
| Facility | | $9,549.93 | $14,454.40 | $28,183.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,548.82 / $2,238.72 / $2,884.03
| Professional | | $1,548.82 | $2,238.72 | $2,884.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,467.37 / $16,595.87 / $30,902.95
| Facility | | $3,467.37 | $16,595.87 | $30,902.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,202.26 / $1,819.70 / $3,162.28
| Professional | | $1,202.26 | $1,819.70 | $3,162.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,096.48 / $1,380.38 / $2,089.30
| Professional | | $1,096.48 | $1,380.38 | $2,089.30 |