- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,884.03 / $9,772.37 / $24,547.09
| Facility | | $2,884.03 | $9,772.37 | $24,547.09 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,230.27 / $1,905.46 / $5,011.87
| Professional | | $1,230.27 | $1,905.46 | $5,011.87 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7,244.36 / $10,232.93 / $20,892.96
| Facility | | $7,244.36 | $10,232.93 | $20,892.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,041.74 / $3,019.95 / $4,570.88
| Professional | | $2,041.74 | $3,019.95 | $4,570.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,445.44 / $1,445.44 / $3,801.89
| Facility | | $1,445.44 | $1,445.44 | $3,801.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,445.44 / $2,398.83 / $4,677.35
| Professional | | $1,445.44 | $2,398.83 | $4,677.35 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,737.80 / $2,187.76 / $4,786.30
| Facility | | $1,737.80 | $2,187.76 | $4,786.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,737.80 / $2,187.76 / $3,981.07
| Professional | | $1,737.80 | $2,187.76 | $3,981.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $616.60
| Professional | | $32.36 | $33.11 | $616.60 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,778.28 / $2,691.53 / $3,019.95
| Facility | | $1,778.28 | $2,691.53 | $3,019.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,995.26 / $1,995.26 / $2,041.74
| Facility | | $1,995.26 | $1,995.26 | $2,041.74 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,041.74 / $3,235.94 / $4,265.80
| Professional | | $2,041.74 | $3,235.94 | $4,265.80 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7,244.36 / $10,715.19 / $20,892.96
| Facility | | $7,244.36 | $10,715.19 | $20,892.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,041.74 / $3,090.30 / $4,677.35
| Professional | | $2,041.74 | $3,090.30 | $4,677.35 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,698.24 / $11,220.18 / $21,877.62
| Facility | | $1,698.24 | $11,220.18 | $21,877.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,584.89 / $2,089.30 / $3,890.45
| Professional | | $1,584.89 | $2,089.30 | $3,890.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $199.53 / $1,819.70 / $2,818.38
| Professional | | $199.53 | $1,819.70 | $2,818.38 |