- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7,244.36 / $8,511.38 / $14,454.40
| Facility | | $7,244.36 | $8,511.38 | $14,454.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,548.13 / $4,168.69 / $4,466.84
| Professional | | $3,548.13 | $4,168.69 | $4,466.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10,232.93 / $13,489.63 / $26,302.68
| Facility | | $10,232.93 | $13,489.63 | $26,302.68 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,388.44 / $6,025.60 / $8,317.64
| Professional | | $3,388.44 | $6,025.60 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6,606.93 / $8,128.31 / $11,481.54
| Professional | | $6,606.93 | $8,128.31 | $11,481.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,548.13 / $6,165.95 / $37,153.52
| Facility | | $3,548.13 | $6,165.95 | $37,153.52 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5,011.87 / $7,943.28 / $28,840.32
| Professional | | $5,011.87 | $7,943.28 | $28,840.32 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7,413.10 / $8,912.51 / $12,022.64
| Professional | | $7,413.10 | $8,912.51 | $12,022.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8,511.38 / $8,511.38 / $8,511.38
| Professional | | $8,511.38 | $8,511.38 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $7.08 / $7.08
| Professional | | $7.08 | $7.08 | $7.08 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,235.94 / $6,165.95 / $8,511.38
| Facility | | $3,235.94 | $6,165.95 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4,466.84 / $7,244.36 / $9,549.93
| Professional | | $4,466.84 | $7,244.36 | $9,549.93 |