- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,454.71 / $3,388.44 / $8,511.38
| Facility | | $2,454.71 | $3,388.44 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,995.26 / $3,467.37 / $8,709.64
| Professional | | $1,995.26 | $3,467.37 | $8,709.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,019.95 / $3,630.78 / $7,079.46
| Professional | | $3,019.95 | $3,630.78 | $7,079.46 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,467.37 / $3,467.37 / $3,467.37
| Facility | | $3,467.37 | $3,467.37 | $3,467.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,467.37 / $3,467.37 / $3,467.37
| Professional | | $3,467.37 | $3,467.37 | $3,467.37 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $34.67 / $4,786.30 / $53,703.18
| Facility | | $34.67 | $4,786.30 | $53,703.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,995.26 / $4,265.80 / $12,022.64
| Professional | | $1,995.26 | $4,265.80 | $12,022.64 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,818.38 / $3,467.37 / $9,120.11
| Facility | | $2,818.38 | $3,467.37 | $9,120.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,290.87 / $3,162.28 / $6,456.54
| Professional | | $2,290.87 | $3,162.28 | $6,456.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,819.70 / $3,019.95 / $5,248.07
| Professional | | $1,819.70 | $3,019.95 | $5,248.07 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,890.45 / $50,118.72 / $75,857.76
| Facility | | $3,890.45 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,630.27 / $3,311.31 / $6,606.93
| Professional | | $2,630.27 | $3,311.31 | $6,606.93 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,479.11 / $4,168.69 / $9,772.37
| Facility | | $1,479.11 | $4,168.69 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,288.25 / $3,548.13 / $6,309.57
| Professional | | $1,288.25 | $3,548.13 | $6,309.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,041.74 / $2,691.53 / $5,754.40
| Facility | | $2,041.74 | $2,691.53 | $5,754.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,949.84 / $3,019.95 / $6,456.54
| Professional | | $1,949.84 | $3,019.95 | $6,456.54 |