- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,677.35 / $10,232.93 / $28,183.83
| Facility | | $4,677.35 | $10,232.93 | $28,183.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,548.13 / $5,248.07 / $9,772.37
| Professional | | $3,548.13 | $5,248.07 | $9,772.37 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8,511.38 / $13,803.84 / $26,915.35
| Facility | | $8,511.38 | $13,803.84 | $26,915.35 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5,248.07 / $7,413.10 / $10,232.93
| Professional | | $5,248.07 | $7,413.10 | $10,232.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4,786.30 / $8,511.38 / $12,022.64
| Professional | | $4,786.30 | $8,511.38 | $12,022.64 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,801.89 / $7,943.28 / $20,417.38
| Facility | | $3,801.89 | $7,943.28 | $20,417.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,715.35 / $7,943.28 / $10,232.93
| Professional | | $3,715.35 | $7,943.28 | $10,232.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $44.67 / $50.12 / $50.12
| Professional | | $44.67 | $50.12 | $50.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,606.93 / $7,943.28 / $7,943.28
| Facility | | $6,606.93 | $7,943.28 | $7,943.28 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,128.61 / $5,128.61 / $5,370.32
| Facility | | $5,128.61 | $5,128.61 | $5,370.32 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5,370.32 / $8,511.38 / $11,481.54
| Professional | | $5,370.32 | $8,511.38 | $11,481.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9,549.93 / $13,803.84 / $26,915.35
| Facility | | $9,549.93 | $13,803.84 | $26,915.35 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5,248.07 / $7,585.78 / $10,232.93
| Professional | | $5,248.07 | $7,585.78 | $10,232.93 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,630.78 / $16,218.10 / $33,884.42
| Facility | | $3,630.78 | $16,218.10 | $33,884.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,890.45 / $5,888.44 / $10,471.29
| Professional | | $3,890.45 | $5,888.44 | $10,471.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,801.89 / $5,128.61 / $7,244.36
| Professional | | $3,801.89 | $5,128.61 | $7,244.36 |