- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $891.25 / $1,995.26 / $14,454.40
| Facility | | $891.25 | $1,995.26 | $14,454.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $891.25 / $1,047.13 / $2,570.40
| Professional | | $891.25 | $1,047.13 | $2,570.40 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,311.31 / $4,786.30 / $7,585.78
| Facility | | $3,311.31 | $4,786.30 | $7,585.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $933.25 / $1,862.09 / $5,011.87
| Professional | | $933.25 | $1,862.09 | $5,011.87 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,511.89 / $2,951.21 / $4,677.35
| Facility | | $2,511.89 | $2,951.21 | $4,677.35 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,445.44 / $3,467.37 / $4,365.16
| Professional | | $1,445.44 | $3,467.37 | $4,365.16 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $977.24 / $7,244.36 / $13,489.63
| Facility | | $977.24 | $7,244.36 | $13,489.63 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,737.80 / $2,398.83 / $3,019.95
| Professional | | $1,737.80 | $2,398.83 | $3,019.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,071.52 / $8,317.64 / $15,848.93
| Facility | | $1,071.52 | $8,317.64 | $15,848.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $891.25 / $1,698.24 / $7,244.36
| Professional | | $891.25 | $1,698.24 | $7,244.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $1,122.02
| Professional | | $32.36 | $33.11 | $1,122.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,995.26 / $9,332.54 / $15,848.93
| Facility | | $1,995.26 | $9,332.54 | $15,848.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,318.26 / $2,454.71 / $4,265.80
| Professional | | $1,318.26 | $2,454.71 | $4,265.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,348.96 / $2,630.27 / $4,365.16
| Professional | | $1,348.96 | $2,630.27 | $4,365.16 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,168.69 / $11,748.98 / $11,748.98
| Facility | | $4,168.69 | $11,748.98 | $11,748.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,862.09 / $4,677.35 / $7,413.10
| Professional | | $1,862.09 | $4,677.35 | $7,413.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,388.44 / $3,388.44 / $3,388.44
| Professional | | $3,388.44 | $3,388.44 | $3,388.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,951.21 / $5,623.41 / $6,760.83
| Professional | | $2,951.21 | $5,623.41 | $6,760.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7,585.78 / $12,022.64 / $14,454.40
| Facility | | $7,585.78 | $12,022.64 | $14,454.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $891.25 / $1,621.81 / $4,168.69
| Professional | | $891.25 | $1,621.81 | $4,168.69 |