- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $794.33 / $1,621.81 / $14,454.40
| Facility | | $794.33 | $1,621.81 | $14,454.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $758.58 / $812.83 / $1,995.26
| Professional | | $758.58 | $812.83 | $1,995.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13,803.84 / $18,197.01 / $29,512.09
| Facility | | $13,803.84 | $18,197.01 | $29,512.09 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $776.25 / $1,513.56 / $3,801.89
| Professional | | $776.25 | $1,513.56 | $3,801.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,041.74 / $2,398.83 / $3,801.89
| Facility | | $2,041.74 | $2,398.83 | $3,801.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $870.96 / $2,511.89 / $2,884.03
| Professional | | $870.96 | $2,511.89 | $2,884.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $794.33 / $3,090.30 / $5,370.32
| Facility | | $794.33 | $3,090.30 | $5,370.32 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,412.54 / $1,949.84 / $2,454.71
| Professional | | $1,412.54 | $1,949.84 | $2,454.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $933.25 / $12,302.69 / $21,379.62
| Facility | | $933.25 | $12,302.69 | $21,379.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $794.33 / $1,412.54 / $5,370.32
| Professional | | $794.33 | $1,412.54 | $5,370.32 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $1,071.52
| Professional | | $32.36 | $33.11 | $1,071.52 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,548.82 / $12,882.50 / $27,542.29
| Facility | | $1,548.82 | $12,882.50 | $27,542.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,071.52 / $1,995.26 / $2,630.27
| Professional | | $1,071.52 | $1,995.26 | $2,630.27 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $933.25 / $1,819.70 / $3,311.31
| Professional | | $933.25 | $1,819.70 | $3,311.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $64,565.42 / $95,499.26 / $95,499.26
| Facility | | $64,565.42 | $95,499.26 | $95,499.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,071.52 / $3,890.45 / $7,079.46
| Professional | | $1,071.52 | $3,890.45 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4,073.80 / $4,073.80 / $4,073.80
| Professional | | $4,073.80 | $4,073.80 | $4,073.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,715.35 / $4,677.35 / $5,754.40
| Professional | | $3,715.35 | $4,677.35 | $5,754.40 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9,549.93 / $17,782.79 / $23,442.29
| Facility | | $9,549.93 | $17,782.79 | $23,442.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $758.58 / $1,318.26 / $3,388.44
| Professional | | $758.58 | $1,318.26 | $3,388.44 |