- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,630.27 / $5,248.07 / $10,964.78
| Facility | | $2,630.27 | $5,248.07 | $10,964.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,691.53 / $3,388.44 / $7,585.78
| Professional | | $2,691.53 | $3,388.44 | $7,585.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,897.79 / $11,220.18 / $18,620.87
| Facility | | $4,897.79 | $11,220.18 | $18,620.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,511.89 / $3,162.28 / $8,128.31
| Professional | | $2,511.89 | $3,162.28 | $8,128.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,168.69 / $4,168.69 / $37,153.52
| Facility | | $4,168.69 | $4,168.69 | $37,153.52 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4,168.69 / $4,168.69 / $4,168.69
| Professional | | $4,168.69 | $4,168.69 | $4,168.69 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $34.67 / $5,128.61 / $50,118.72
| Facility | | $34.67 | $5,128.61 | $50,118.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,951.21 / $4,786.30 / $16,595.87
| Professional | | $2,951.21 | $4,786.30 | $16,595.87 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,162.28 / $5,128.61 / $11,481.54
| Facility | | $3,162.28 | $5,128.61 | $11,481.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,162.28 / $4,786.30 / $7,079.46
| Professional | | $3,162.28 | $4,786.30 | $7,079.46 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,754.23 / $2,754.23 / $2,754.23
| Facility | | $2,754.23 | $2,754.23 | $2,754.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,511.89 / $3,801.89 / $6,309.57
| Professional | | $2,511.89 | $3,801.89 | $6,309.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,019.95 / $50,118.72 / $75,857.76
| Facility | | $3,019.95 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $398.11 / $3,981.07 / $6,456.54
| Professional | | $398.11 | $3,981.07 | $6,456.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,479.11 / $4,073.80 / $9,772.37
| Facility | | $1,479.11 | $4,073.80 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,818.38 / $4,786.30 / $16,595.87
| Professional | | $2,818.38 | $4,786.30 | $16,595.87 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,398.83 / $3,467.37 / $12,882.50
| Facility | | $2,398.83 | $3,467.37 | $12,882.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,398.83 / $3,630.78 / $8,709.64
| Professional | | $2,398.83 | $3,630.78 | $8,709.64 |