- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,019.95 / $4,073.80 / $20,892.96
| Facility | | $3,019.95 | $4,073.80 | $20,892.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,412.54 / $1,995.26 / $3,981.07
| Professional | | $1,412.54 | $1,995.26 | $3,981.07 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11,220.18 / $17,782.79 / $36,307.81
| Facility | | $11,220.18 | $17,782.79 | $36,307.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,238.72 / $3,235.94 / $4,168.69
| Professional | | $2,238.72 | $3,235.94 | $4,168.69 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,365.16 / $4,365.16 / $7,244.36
| Facility | | $4,365.16 | $4,365.16 | $7,244.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,949.84 / $3,019.95 / $4,786.30
| Professional | | $1,949.84 | $3,019.95 | $4,786.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,041.74 / $3,630.78 / $16,982.44
| Facility | | $2,041.74 | $3,630.78 | $16,982.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,041.74 / $3,467.37 / $4,570.88
| Professional | | $2,041.74 | $3,467.37 | $4,570.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $64.57
| Professional | | $32.36 | $33.11 | $64.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,621.81 / $3,090.30 / $3,311.31
| Facility | | $1,621.81 | $3,090.30 | $3,311.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,187.76 / $2,187.76 / $2,238.72
| Facility | | $2,187.76 | $2,187.76 | $2,238.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,238.72 / $3,467.37 / $4,786.30
| Professional | | $2,238.72 | $3,467.37 | $4,786.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12,302.69 / $18,620.87 / $36,307.81
| Facility | | $12,302.69 | $18,620.87 | $36,307.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,238.72 / $3,235.94 / $4,168.69
| Professional | | $2,238.72 | $3,235.94 | $4,168.69 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,162.28 / $11,481.54 / $19,498.45
| Facility | | $3,162.28 | $11,481.54 | $19,498.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,659.59 / $2,454.71 / $4,570.88
| Professional | | $1,659.59 | $2,454.71 | $4,570.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,698.24 / $2,089.30 / $3,162.28
| Professional | | $1,698.24 | $2,089.30 | $3,162.28 |