- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $851.14 / $4,570.88 / $10,715.19
| Facility | | $851.14 | $4,570.88 | $10,715.19 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $380.19 / $1,071.52 / $5,623.41
| Professional | | $380.19 | $1,071.52 | $5,623.41 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12,022.64 / $16,982.44 / $28,840.32
| Facility | | $12,022.64 | $16,982.44 | $28,840.32 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $602.56 / $1,071.52 / $2,344.23
| Professional | | $602.56 | $1,071.52 | $2,344.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $467.74 / $467.74 / $467.74
| Facility | | $467.74 | $467.74 | $467.74 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,309.57 / $7,244.36 / $11,748.98
| Facility | | $6,309.57 | $7,244.36 | $11,748.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $660.69 / $1,862.09 / $10,471.29
| Professional | | $660.69 | $1,862.09 | $10,471.29 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $407.38 / $2,238.72 / $4,570.88
| Facility | | $407.38 | $2,238.72 | $4,570.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $758.58 / $1,445.44 / $5,888.44
| Professional | | $758.58 | $1,445.44 | $5,888.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $416.87 / $2,454.71 / $14,125.38
| Facility | | $416.87 | $2,454.71 | $14,125.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,659.59 / $3,715.35 / $16,982.44
| Professional | | $1,659.59 | $3,715.35 | $16,982.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $85.11
| Professional | | $32.36 | $33.11 | $85.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $870.96 / $10,715.19 / $17,378.01
| Facility | | $870.96 | $10,715.19 | $17,378.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $794.33 / $2,137.96 / $6,760.83
| Professional | | $794.33 | $2,137.96 | $6,760.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $724.44 / $2,630.27 / $7,762.47
| Professional | | $724.44 | $2,630.27 | $7,762.47 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $19,498.45 / $28,840.32 / $28,840.32
| Facility | | $19,498.45 | $28,840.32 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- 53
- Typical Low / Median / Typical High
- $3,890.45 / $3,890.45 / $5,754.40
| Facility | 53 | $3,890.45 | $3,890.45 | $5,754.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $794.33 / $9,332.54 / $15,848.93
| Professional | | $794.33 | $9,332.54 | $15,848.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,445.44 / $1,445.44 / $8,511.38
| Professional | | $1,445.44 | $1,445.44 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,479.11 / $2,691.53 / $13,489.63
| Professional | | $1,479.11 | $2,691.53 | $13,489.63 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,165.95 / $13,803.84 / $17,378.01
| Facility | | $6,165.95 | $13,803.84 | $17,378.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $467.74 / $1,659.59 / $5,623.41
| Professional | | $467.74 | $1,659.59 | $5,623.41 |