- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,981.07 / $10,715.19 / $24,547.09
| Facility | | $3,981.07 | $10,715.19 | $24,547.09 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,454.71 / $3,235.94 / $10,964.78
| Professional | | $2,454.71 | $3,235.94 | $10,964.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,918.31 / $11,748.98 / $20,892.96
| Facility | | $6,918.31 | $11,748.98 | $20,892.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,162.28 / $4,365.16 / $8,317.64
| Professional | | $3,162.28 | $4,365.16 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $79.43 / $8,128.31 / $15,488.17
| Facility | | $79.43 | $8,128.31 | $15,488.17 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,570.40 / $3,630.78 / $7,413.10
| Professional | | $2,570.40 | $3,630.78 | $7,413.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,570.40 / $3,388.44 / $7,079.46
| Professional | | $2,570.40 | $3,388.44 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,995.26 / $2,818.38 / $3,548.13
| Professional | | $1,995.26 | $2,818.38 | $3,548.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,344.23 / $3,090.30 / $7,079.46
| Professional | | $2,344.23 | $3,090.30 | $7,079.46 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,011.87 / $5,011.87 / $16,982.44
| Facility | | $5,011.87 | $5,011.87 | $16,982.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19,498.45 / $25,118.86 / $25,118.86
| Professional | | $19,498.45 | $25,118.86 | $25,118.86 |
- 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
- Professional
- Modifier
- Typical Low / Median / Typical High
- $54.95 / $54.95 / $70.79
| Professional | | $54.95 | $54.95 | $70.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,570.40 / $3,388.44 / $5,495.41
| Facility | | $2,570.40 | $3,388.44 | $5,495.41 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,570.40 / $3,388.44 / $7,079.46
| Professional | | $2,570.40 | $3,388.44 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8,709.64 / $8,709.64 / $8,709.64
| Professional | | $8,709.64 | $8,709.64 | $8,709.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,290.87 / $3,019.95 / $4,265.80
| Professional | | $2,290.87 | $3,019.95 | $4,265.80 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8,912.51 / $16,982.44 / $37,153.52
| Facility | | $8,912.51 | $16,982.44 | $37,153.52 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,187.76 / $2,951.21 / $6,456.54
| Professional | | $2,187.76 | $2,951.21 | $6,456.54 |