- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,187.76 / $6,025.60 / $18,620.87
| Facility | | $2,187.76 | $6,025.60 | $18,620.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,023.29 / $1,380.38 / $2,951.21
| Professional | | $1,023.29 | $1,380.38 | $2,951.21 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,168.69 / $5,370.32 / $11,220.18
| Facility | | $4,168.69 | $5,370.32 | $11,220.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,621.81 / $2,290.87 / $3,235.94
| Professional | | $1,621.81 | $2,290.87 | $3,235.94 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $630.96 / $758.58 / $2,630.27
| Facility | | $630.96 | $758.58 | $2,630.27 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,047.13 / $1,905.46 / $3,548.13
| Professional | | $1,047.13 | $1,905.46 | $3,548.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,174.90 / $1,819.70 / $3,235.94
| Facility | | $1,174.90 | $1,819.70 | $3,235.94 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,148.15 / $1,819.70 / $2,884.03
| Professional | | $1,148.15 | $1,819.70 | $2,884.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $512.86
| Professional | | $32.36 | $33.11 | $512.86 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,778.28 / $2,238.72 / $2,344.23
| Facility | | $1,778.28 | $2,238.72 | $2,344.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,584.89 / $1,584.89 / $1,621.81
| Facility | | $1,584.89 | $1,584.89 | $1,621.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,621.81 / $2,344.23 / $3,090.30
| Professional | | $1,621.81 | $2,344.23 | $3,090.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,981.07 / $5,495.41 / $10,471.29
| Facility | | $3,981.07 | $5,495.41 | $10,471.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,621.81 / $2,290.87 / $3,162.28
| Professional | | $1,621.81 | $2,290.87 | $3,162.28 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,819.70 / $6,309.57 / $12,022.64
| Facility | | $1,819.70 | $6,309.57 | $12,022.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,202.26 / $1,698.24 / $3,090.30
| Professional | | $1,202.26 | $1,698.24 | $3,090.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,148.15 / $1,230.27 / $2,187.76
| Professional | | $1,148.15 | $1,230.27 | $2,187.76 |