- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,884.03 / $4,466.84 / $5,495.41
| Facility | | $2,884.03 | $4,466.84 | $5,495.41 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,258.93 / $1,698.24 / $3,311.31
| Professional | | $1,258.93 | $1,698.24 | $3,311.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,511.89 / $7,585.78 / $17,378.01
| Facility | | $2,511.89 | $7,585.78 | $17,378.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,238.72 / $2,630.27 / $2,691.53
| Professional | | $2,238.72 | $2,630.27 | $2,691.53 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,715.35 / $3,715.35 / $3,715.35
| Facility | | $3,715.35 | $3,715.35 | $3,715.35 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,258.93 / $1,862.09 / $2,398.83
| Professional | | $1,258.93 | $1,862.09 | $2,398.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,288.25 / $2,041.74 / $4,073.80
| Facility | | $1,288.25 | $2,041.74 | $4,073.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,041.74 / $2,344.23 / $3,235.94
| Professional | | $2,041.74 | $2,344.23 | $3,235.94 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $32.36 / $33.11
| Professional | | $32.36 | $32.36 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10,964.78 / $15,135.61 / $21,379.62
| Facility | | $10,964.78 | $15,135.61 | $21,379.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,238.72 / $2,754.23 / $2,884.03
| Professional | | $2,238.72 | $2,754.23 | $2,884.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,122.02 / $1,548.82 / $10,964.78
| Professional | | $1,122.02 | $1,548.82 | $10,964.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,089.30 / $17,782.79 / $27,542.29
| Facility | | $2,089.30 | $17,782.79 | $27,542.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,288.25 / $2,041.74 / $2,818.38
| Professional | | $1,288.25 | $2,041.74 | $2,818.38 |