- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,819.70 / $4,570.88 / $10,964.78
| Facility | | $1,819.70 | $4,570.88 | $10,964.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,258.93 / $1,659.59 / $3,890.45
| Professional | | $1,258.93 | $1,659.59 | $3,890.45 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,073.80 / $7,762.47 / $13,803.84
| Facility | | $4,073.80 | $7,762.47 | $13,803.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,071.52 / $1,348.96 / $3,715.35
| Professional | | $1,071.52 | $1,348.96 | $3,715.35 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,995.26 / $1,995.26 / $8,912.51
| Facility | | $1,995.26 | $1,995.26 | $8,912.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,995.26 / $1,995.26 / $1,995.26
| Professional | | $1,995.26 | $1,995.26 | $1,995.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,290.87 / $2,398.83 / $50,118.72
| Facility | | $2,290.87 | $2,398.83 | $50,118.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,380.38 / $2,238.72 / $6,918.31
| Professional | | $1,380.38 | $2,238.72 | $6,918.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,548.82 / $1,995.26 / $5,011.87
| Facility | | $1,548.82 | $1,995.26 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,380.38 / $2,089.30 / $2,951.21
| Professional | | $1,380.38 | $2,089.30 | $2,951.21 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,318.26 / $1,318.26 / $1,318.26
| Facility | | $1,318.26 | $1,318.26 | $1,318.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,174.90 / $1,819.70 / $3,019.95
| Professional | | $1,174.90 | $1,819.70 | $3,019.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,445.44 / $50,118.72 / $75,857.76
| Facility | | $1,445.44 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $398.11 / $1,995.26 / $3,162.28
| Professional | | $398.11 | $1,995.26 | $3,162.28 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,398.83 / $5,495.41 / $16,218.10
| Facility | | $2,398.83 | $5,495.41 | $16,218.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,288.25 / $2,137.96 / $7,244.36
| Professional | | $1,288.25 | $2,137.96 | $7,244.36 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,148.15 / $1,659.59 / $6,025.60
| Facility | | $1,148.15 | $1,659.59 | $6,025.60 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,148.15 / $1,737.80 / $4,073.80
| Professional | | $1,148.15 | $1,737.80 | $4,073.80 |