- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,981.07 / $10,471.29 / $22,908.68
| Facility | | $3,981.07 | $10,471.29 | $22,908.68 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,621.81 / $2,089.30 / $6,918.31
| Professional | | $1,621.81 | $2,089.30 | $6,918.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7,943.28 / $13,803.84 / $22,387.21
| Facility | | $7,943.28 | $13,803.84 | $22,387.21 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,344.23 / $3,162.28 / $6,456.54
| Professional | | $2,344.23 | $3,162.28 | $6,456.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $79.43 / $5,754.40 / $10,715.19
| Facility | | $79.43 | $5,754.40 | $10,715.19 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,819.70 / $2,754.23 / $5,754.40
| Professional | | $1,819.70 | $2,754.23 | $5,754.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,737.80 / $2,344.23 / $5,370.32
| Professional | | $1,737.80 | $2,344.23 | $5,370.32 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,479.11 / $1,995.26 / $2,511.89
| Professional | | $1,479.11 | $1,995.26 | $2,511.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,737.80 / $2,290.87 / $4,570.88
| Professional | | $1,737.80 | $2,290.87 | $4,570.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $54.95 / $56.23 / $12,022.64
| Facility | | $54.95 | $56.23 | $12,022.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13,803.84 / $17,782.79 / $17,782.79
| Professional | | $13,803.84 | $17,782.79 | $17,782.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,951.21 / $2,951.21 / $2,951.21
| Professional | | $2,951.21 | $2,951.21 | $2,951.21 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,862.09 / $2,398.83 / $3,890.45
| Facility | | $1,862.09 | $2,398.83 | $3,890.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,698.24 / $2,344.23 / $5,128.61
| Professional | | $1,698.24 | $2,344.23 | $5,128.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6,165.95 / $6,165.95 / $6,165.95
| Professional | | $6,165.95 | $6,165.95 | $6,165.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,621.81 / $2,187.76 / $3,162.28
| Professional | | $1,621.81 | $2,187.76 | $3,162.28 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,949.84 / $6,165.95 / $18,620.87
| Facility | | $1,949.84 | $6,165.95 | $18,620.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,548.82 / $2,137.96 / $5,888.44
| Professional | | $1,548.82 | $2,137.96 | $5,888.44 |