- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,412.54 / $1,412.54 / $24,547.09
| Facility | | $1,412.54 | $1,412.54 | $24,547.09 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,174.90 / $1,548.82 / $4,677.35
| Professional | | $1,174.90 | $1,548.82 | $4,677.35 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $56.23 / $4,265.80 / $12,882.50
| Facility | | $56.23 | $4,265.80 | $12,882.50 |
- Facility/Professional
- Facility
- Modifier
- AS
- Typical Low / Median / Typical High
- $851.14 / $851.14 / $851.14
| Facility | AS | $851.14 | $851.14 | $851.14 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,023.29 / $1,905.46 / $6,456.54
| Professional | | $1,023.29 | $1,905.46 | $6,456.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,162.28 / $3,162.28 / $3,162.28
| Professional | | $3,162.28 | $3,162.28 | $3,162.28 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $51,286.14 / $54,954.09 / $61,659.50
| Facility | | $51,286.14 | $54,954.09 | $61,659.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $616.60 / $2,187.76 / $4,365.16
| Professional | | $616.60 | $2,187.76 | $4,365.16 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,318.26 / $1,905.46 / $3,890.45
| Facility | | $1,318.26 | $1,905.46 | $3,890.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,445.44 / $1,778.28 / $2,187.76
| Professional | | $1,445.44 | $1,778.28 | $2,187.76 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,090.30 / $6,918.31 / $15,488.17
| Facility | | $3,090.30 | $6,918.31 | $15,488.17 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,380.38 / $2,454.71 / $3,715.35
| Professional | | $1,380.38 | $2,454.71 | $3,715.35 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $56.23 / $4,265.80 / $12,882.50
| Facility | | $56.23 | $4,265.80 | $12,882.50 |
- Facility/Professional
- Facility
- Modifier
- AS
- Typical Low / Median / Typical High
- $851.14 / $851.14 / $851.14
| Facility | AS | $851.14 | $851.14 | $851.14 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,023.29 / $1,905.46 / $6,456.54
| Professional | | $1,023.29 | $1,905.46 | $6,456.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,398.83 / $6,025.60 / $14,125.38
| Facility | | $2,398.83 | $6,025.60 | $14,125.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,096.48 / $2,238.72 / $4,365.16
| Professional | | $1,096.48 | $2,238.72 | $4,365.16 |