- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,621.81 / $4,466.84 / $18,620.87
| Facility | | $1,621.81 | $4,466.84 | $18,620.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $794.33 / $1,148.15 / $2,187.76
| Professional | | $794.33 | $1,148.15 | $2,187.76 |
- 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
- $1,174.90 / $1,659.59 / $2,187.76
| Professional | | $1,174.90 | $1,659.59 | $2,187.76 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,548.13 / $3,548.13 / $6,025.60
| Facility | | $3,548.13 | $3,548.13 | $6,025.60 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,047.13 / $1,659.59 / $2,570.40
| Professional | | $1,047.13 | $1,659.59 | $2,570.40 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,148.15 / $2,041.74 / $13,182.57
| Facility | | $1,148.15 | $2,041.74 | $13,182.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,096.48 / $1,949.84 / $4,897.79
| Professional | | $1,096.48 | $1,949.84 | $4,897.79 |
- 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
- $1,071.52 / $1,698.24 / $1,698.24
| Facility | | $1,071.52 | $1,698.24 | $1,698.24 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,148.15 / $1,148.15 / $1,202.26
| Facility | | $1,148.15 | $1,148.15 | $1,202.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,202.26 / $1,862.09 / $2,570.40
| Professional | | $1,202.26 | $1,862.09 | $2,570.40 |
- 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
- $1,174.90 / $1,698.24 / $2,344.23
| Professional | | $1,174.90 | $1,698.24 | $2,344.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,691.53 / $16,595.87 / $30,902.95
| Facility | | $2,691.53 | $16,595.87 | $30,902.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $912.01 / $1,380.38 / $2,398.83
| Professional | | $912.01 | $1,380.38 | $2,398.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $851.14 / $1,071.52 / $1,621.81
| Professional | | $851.14 | $1,071.52 | $1,621.81 |