- 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
- $3,715.35 / $5,370.32 / $6,760.83
| Professional | | $3,715.35 | $5,370.32 | $6,760.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7,079.46 / $9,549.93 / $19,054.61
| Facility | | $7,079.46 | $9,549.93 | $19,054.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5,623.41 / $7,943.28 / $10,715.19
| Professional | | $5,623.41 | $7,943.28 | $10,715.19 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5,011.87 / $9,120.11 / $12,589.25
| Professional | | $5,011.87 | $9,120.11 | $12,589.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,090.30 / $8,709.64 / $14,125.38
| Facility | | $3,090.30 | $8,709.64 | $14,125.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,818.38 / $8,511.38 / $10,964.78
| Professional | | $2,818.38 | $8,511.38 | $10,964.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $44.67 / $50.12 / $64.57
| Professional | | $44.67 | $50.12 | $64.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,011.87 / $8,317.64 / $8,317.64
| Facility | | $5,011.87 | $8,317.64 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,495.41 / $5,495.41 / $5,754.40
| Facility | | $5,495.41 | $5,495.41 | $5,754.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5,754.40 / $8,912.51 / $12,022.64
| Professional | | $5,754.40 | $8,912.51 | $12,022.64 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,606.93 / $9,772.37 / $19,054.61
| Facility | | $6,606.93 | $9,772.37 | $19,054.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5,623.41 / $8,128.31 / $10,715.19
| Professional | | $5,623.41 | $8,128.31 | $10,715.19 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,235.94 / $11,220.18 / $23,988.33
| Facility | | $3,235.94 | $11,220.18 | $23,988.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4,073.80 / $6,165.95 / $10,964.78
| Professional | | $4,073.80 | $6,165.95 | $10,964.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4,073.80 / $5,495.41 / $7,585.78
| Professional | | $4,073.80 | $5,495.41 | $7,585.78 |