- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,318.26 / $2,511.89 / $14,454.40
| Facility | | $1,318.26 | $2,511.89 | $14,454.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,122.02 / $1,318.26 / $3,090.30
| Professional | | $1,122.02 | $1,318.26 | $3,090.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9,120.11 / $12,882.50 / $22,387.21
| Facility | | $9,120.11 | $12,882.50 | $22,387.21 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,202.26 / $2,344.23 / $5,623.41
| Professional | | $1,202.26 | $2,344.23 | $5,623.41 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,162.28 / $3,715.35 / $5,888.44
| Facility | | $3,162.28 | $3,715.35 | $5,888.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,380.38 / $3,630.78 / $4,168.69
| Professional | | $1,380.38 | $3,630.78 | $4,168.69 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,318.26 / $7,244.36 / $13,489.63
| Facility | | $1,318.26 | $7,244.36 | $13,489.63 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,137.96 / $3,019.95 / $3,715.35
| Professional | | $2,137.96 | $3,019.95 | $3,715.35 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,318.26 / $3,162.28 / $7,943.28
| Facility | | $1,318.26 | $3,162.28 | $7,943.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,230.27 / $2,187.76 / $5,754.40
| Professional | | $1,230.27 | $2,187.76 | $5,754.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $1,659.59
| Professional | | $32.36 | $33.11 | $1,659.59 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,819.70 / $1,819.70 / $2,511.89
| Facility | | $1,819.70 | $1,819.70 | $2,511.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,698.24 / $3,019.95 / $3,890.45
| Professional | | $1,698.24 | $3,019.95 | $3,890.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,412.54 / $2,754.23 / $3,981.07
| Professional | | $1,412.54 | $2,754.23 | $3,981.07 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,090.30 / $9,772.37 / $9,772.37
| Facility | | $3,090.30 | $9,772.37 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,819.70 / $6,025.60 / $8,912.51
| Professional | | $1,819.70 | $6,025.60 | $8,912.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,019.95 / $3,019.95 / $3,019.95
| Professional | | $3,019.95 | $3,019.95 | $3,019.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,235.94 / $6,606.93 / $6,606.93
| Professional | | $3,235.94 | $6,606.93 | $6,606.93 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,290.87 / $7,079.46 / $19,498.45
| Facility | | $2,290.87 | $7,079.46 | $19,498.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,096.48 / $2,137.96 / $5,248.07
| Professional | | $1,096.48 | $2,137.96 | $5,248.07 |