- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $812.83 / $6,456.54 / $22,387.21
| Facility | | $812.83 | $6,456.54 | $22,387.21 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $758.58 / $3,388.44 / $11,220.18
| Professional | | $758.58 | $3,388.44 | $11,220.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12,882.50 / $17,378.01 / $28,840.32
| Facility | | $12,882.50 | $17,378.01 | $28,840.32 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,202.26 / $6,025.60 / $23,442.29
| Professional | | $1,202.26 | $6,025.60 | $23,442.29 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15,488.17 / $18,197.01 / $28,840.32
| Facility | | $15,488.17 | $18,197.01 | $28,840.32 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,148.15 / $2,754.23 / $20,892.96
| Professional | | $1,148.15 | $2,754.23 | $20,892.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $891.25 / $5,128.61 / $9,772.37
| Facility | | $891.25 | $5,128.61 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,621.81 / $2,511.89 / $16,218.10
| Professional | | $1,621.81 | $2,511.89 | $16,218.10 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $954.99 / $10,715.19 / $19,952.62
| Facility | | $954.99 | $10,715.19 | $19,952.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,819.70 / $12,022.64 / $33,113.11
| Professional | | $1,819.70 | $12,022.64 | $33,113.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $2,344.23
| Professional | | $32.36 | $33.11 | $2,344.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,513.56 / $12,882.50 / $27,542.29
| Facility | | $1,513.56 | $12,882.50 | $27,542.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,819.70 / $8,912.51 / $20,892.96
| Professional | | $1,819.70 | $8,912.51 | $20,892.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,348.96 / $6,309.57 / $19,498.45
| Professional | | $1,348.96 | $6,309.57 | $19,498.45 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $26,915.35 / $38,904.51 / $38,904.51
| Facility | | $26,915.35 | $38,904.51 | $38,904.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,148.15 / $18,197.01 / $38,904.51
| Professional | | $1,148.15 | $18,197.01 | $38,904.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,089.30 / $2,089.30 / $16,595.87
| Professional | | $2,089.30 | $2,089.30 | $16,595.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,630.27 / $19,498.45 / $28,183.83
| Professional | | $2,630.27 | $19,498.45 | $28,183.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9,549.93 / $17,378.01 / $22,908.68
| Facility | | $9,549.93 | $17,378.01 | $22,908.68 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $977.24 / $3,715.35 / $23,988.33
| Professional | | $977.24 | $3,715.35 | $23,988.33 |