- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,096.48 / $3,715.35 / $12,882.50
| Facility | | $1,096.48 | $3,715.35 | $12,882.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,174.90 / $1,445.44 / $2,454.71
| Professional | | $1,174.90 | $1,445.44 | $2,454.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,128.61 / $9,549.93 / $18,620.87
| Facility | | $5,128.61 | $9,549.93 | $18,620.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,258.93 / $1,548.82 / $2,137.96
| Professional | | $1,258.93 | $1,548.82 | $2,137.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,258.93 / $5,888.44 / $5,888.44
| Facility | | $1,258.93 | $5,888.44 | $5,888.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,344.23 / $3,630.78 / $6,918.31
| Facility | | $2,344.23 | $3,630.78 | $6,918.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,288.25 / $1,862.09 / $2,951.21
| Professional | | $1,288.25 | $1,862.09 | $2,951.21 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,011.87 / $30,199.52 / $30,199.52
| Facility | | $5,011.87 | $30,199.52 | $30,199.52 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11,481.54 / $12,022.64 / $12,022.64
| Professional | | $11,481.54 | $12,022.64 | $12,022.64 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,202.26 / $1,905.46 / $5,011.87
| Facility | | $1,202.26 | $1,905.46 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,202.26 / $1,819.70 / $2,951.21
| Professional | | $1,202.26 | $1,819.70 | $2,951.21 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $1,174.90
| Professional | | $32.36 | $33.11 | $1,174.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,737.80 / $4,570.88 / $4,786.30
| Professional | | $1,737.80 | $4,570.88 | $4,786.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,288.25 / $1,778.28 / $3,235.94
| Facility | | $1,288.25 | $1,778.28 | $3,235.94 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,258.93 / $1,862.09 / $2,884.03
| Professional | | $1,258.93 | $1,862.09 | $2,884.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,754.23 / $7,413.10 / $14,454.40
| Facility | | $2,754.23 | $7,413.10 | $14,454.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,122.02 / $1,513.56 / $2,344.23
| Professional | | $1,122.02 | $1,513.56 | $2,344.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,230.27 / $1,258.93 / $1,380.38
| Professional | | $1,230.27 | $1,258.93 | $1,380.38 |