- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,398.83 / $4,466.84 / $18,620.87
| Facility | | $2,398.83 | $4,466.84 | $18,620.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,096.48 / $1,513.56 / $3,235.94
| Professional | | $1,096.48 | $1,513.56 | $3,235.94 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11,220.18 / $17,782.79 / $36,307.81
| Facility | | $11,220.18 | $17,782.79 | $36,307.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,778.28 / $2,570.40 / $3,548.13
| Professional | | $1,778.28 | $2,570.40 | $3,548.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $467.74 / $501.19 / $7,244.36
| Facility | | $467.74 | $501.19 | $7,244.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,174.90 / $2,137.96 / $3,890.45
| Professional | | $1,174.90 | $2,137.96 | $3,890.45 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,348.96 / $2,630.27 / $9,332.54
| Facility | | $1,348.96 | $2,630.27 | $9,332.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,318.26 / $2,511.89 / $7,413.10
| Professional | | $1,318.26 | $2,511.89 | $7,413.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $97.72
| Professional | | $32.36 | $33.11 | $97.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,621.81 / $2,511.89 / $2,630.27
| Facility | | $1,621.81 | $2,511.89 | $2,630.27 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,737.80 / $1,778.28 / $1,819.70
| Facility | | $1,737.80 | $1,778.28 | $1,819.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,778.28 / $2,630.27 / $3,388.44
| Professional | | $1,778.28 | $2,630.27 | $3,388.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12,302.69 / $18,620.87 / $36,307.81
| Facility | | $12,302.69 | $18,620.87 | $36,307.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,778.28 / $2,511.89 / $3,548.13
| Professional | | $1,778.28 | $2,511.89 | $3,548.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,467.37 / $25,118.86 / $50,118.72
| Facility | | $3,467.37 | $25,118.86 | $50,118.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,318.26 / $1,905.46 / $3,388.44
| Professional | | $1,318.26 | $1,905.46 | $3,388.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,258.93 / $1,348.96 / $2,398.83
| Professional | | $1,258.93 | $1,348.96 | $2,398.83 |