- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,398.83 / $7,943.28 / $14,454.40
| Facility | | $2,398.83 | $7,943.28 | $14,454.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,174.90 / $1,513.56 / $7,079.46
| Professional | | $1,174.90 | $1,513.56 | $7,079.46 |
- 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
- $1,148.15 / $1,949.84 / $2,630.27
| Professional | | $1,148.15 | $1,949.84 | $2,630.27 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,412.54 / $2,951.21 / $3,801.89
| Professional | | $1,412.54 | $2,951.21 | $3,801.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,513.56 / $2,691.53 / $12,302.69
| Facility | | $1,513.56 | $2,691.53 | $12,302.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,584.89 / $2,570.40 / $10,715.19
| Professional | | $1,584.89 | $2,570.40 | $10,715.19 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,884.03 / $2,951.21 / $3,981.07
| Professional | | $2,884.03 | $2,951.21 | $3,981.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,818.38 / $2,818.38 / $2,818.38
| Professional | | $2,818.38 | $2,818.38 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $2,187.76 / $3,311.31
| Professional | | $7.08 | $2,187.76 | $3,311.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,754.40 / $8,709.64 / $13,489.63
| Facility | | $5,754.40 | $8,709.64 | $13,489.63 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,584.89 / $2,290.87 / $3,162.28
| Professional | | $1,584.89 | $2,290.87 | $3,162.28 |