- 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
- $3,801.89 / $4,466.84 / $4,677.35
| Professional | | $3,801.89 | $4,466.84 | $4,677.35 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10,000.00 / $13,182.57 / $25,703.96
| Facility | | $10,000.00 | $13,182.57 | $25,703.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,548.13 / $6,309.57 / $8,912.51
| Professional | | $3,548.13 | $6,309.57 | $8,912.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,981.07 / $8,912.51 / $12,589.25
| Professional | | $3,981.07 | $8,912.51 | $12,589.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,801.89 / $5,623.41 / $38,904.51
| Facility | | $3,801.89 | $5,623.41 | $38,904.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5,128.61 / $8,317.64 / $30,199.52
| Professional | | $5,128.61 | $8,317.64 | $30,199.52 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7,943.28 / $9,549.93 / $12,589.25
| Professional | | $7,943.28 | $9,549.93 | $12,589.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8,912.51 / $8,912.51 / $8,912.51
| Professional | | $8,912.51 | $8,912.51 | $8,912.51 |
- 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
- $3,090.30 / $4,466.84 / $6,918.31
| Facility | | $3,090.30 | $4,466.84 | $6,918.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4,677.35 / $7,585.78 / $10,232.93
| Professional | | $4,677.35 | $7,585.78 | $10,232.93 |