- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,548.82 / $9,120.11 / $20,892.96
| Facility | | $1,548.82 | $9,120.11 | $20,892.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $741.31 / $1,071.52 / $2,238.72
| Professional | | $741.31 | $1,071.52 | $2,238.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7,079.46 / $9,332.54 / $19,054.61
| Facility | | $7,079.46 | $9,332.54 | $19,054.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,096.48 / $1,584.89 / $2,089.30
| Professional | | $1,096.48 | $1,584.89 | $2,089.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,344.23 / $2,344.23 / $3,890.45
| Facility | | $2,344.23 | $2,344.23 | $3,890.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $977.24 / $1,548.82 / $2,454.71
| Professional | | $977.24 | $1,548.82 | $2,454.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,071.52 / $1,949.84 / $9,549.93
| Facility | | $1,071.52 | $1,949.84 | $9,549.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,023.29 / $1,778.28 / $3,090.30
| Professional | | $1,023.29 | $1,778.28 | $3,090.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $56.23
| Professional | | $32.36 | $33.11 | $56.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,202.26 / $1,584.89 / $1,659.59
| Facility | | $1,202.26 | $1,584.89 | $1,659.59 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,096.48 / $1,096.48 / $1,122.02
| Facility | | $1,096.48 | $1,096.48 | $1,122.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,122.02 / $1,737.80 / $2,398.83
| Professional | | $1,122.02 | $1,737.80 | $2,398.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,606.93 / $9,549.93 / $19,054.61
| Facility | | $6,606.93 | $9,549.93 | $19,054.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,096.48 / $1,584.89 / $2,089.30
| Professional | | $1,096.48 | $1,584.89 | $2,089.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,235.94 / $10,964.78 / $19,952.62
| Facility | | $3,235.94 | $10,964.78 | $19,952.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $851.14 / $1,288.25 / $2,238.72
| Professional | | $851.14 | $1,288.25 | $2,238.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $794.33 / $1,000.00 / $1,513.56
| Professional | | $794.33 | $1,000.00 | $1,513.56 |