- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,778.28 / $5,754.40 / $13,489.63
| Facility | | $1,778.28 | $5,754.40 | $13,489.63 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,096.48 / $1,348.96 / $2,884.03
| Professional | | $1,096.48 | $1,348.96 | $2,884.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,606.93 / $10,964.78 / $18,197.01
| Facility | | $6,606.93 | $10,964.78 | $18,197.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,148.15 / $2,290.87 / $5,623.41
| Professional | | $1,148.15 | $2,290.87 | $5,623.41 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,090.30 / $3,630.78 / $5,754.40
| Facility | | $3,090.30 | $3,630.78 | $5,754.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,698.24 / $3,801.89 / $4,365.16
| Professional | | $1,698.24 | $3,801.89 | $4,365.16 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,288.25 / $6,309.57 / $13,182.57
| Facility | | $1,288.25 | $6,309.57 | $13,182.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,187.76 / $2,951.21 / $3,467.37
| Professional | | $2,187.76 | $2,951.21 | $3,467.37 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,288.25 / $7,244.36 / $15,848.93
| Facility | | $1,288.25 | $7,244.36 | $15,848.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,202.26 / $2,290.87 / $8,709.64
| Professional | | $1,202.26 | $2,290.87 | $8,709.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $85.11
| Professional | | $32.36 | $33.11 | $85.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,398.83 / $9,332.54 / $15,848.93
| Facility | | $2,398.83 | $9,332.54 | $15,848.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,445.44 / $3,388.44 / $5,248.07
| Professional | | $1,445.44 | $3,388.44 | $5,248.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,096.48 / $2,344.23 / $3,630.78
| Professional | | $1,096.48 | $2,344.23 | $3,630.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8,128.31 / $11,748.98 / $11,748.98
| Facility | | $8,128.31 | $11,748.98 | $11,748.98 |
- Facility/Professional
- Facility
- Modifier
- 54
- Typical Low / Median / Typical High
- $5,623.41 / $8,317.64 / $8,317.64
| Facility | 54 | $5,623.41 | $8,317.64 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,905.46 / $5,754.40 / $8,511.38
| Professional | | $1,905.46 | $5,754.40 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5,495.41 / $5,495.41 / $5,495.41
| Professional | | $5,495.41 | $5,495.41 | $5,495.41 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,606.93 / $6,606.93 / $6,606.93
| Facility | | $6,606.93 | $6,606.93 | $6,606.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,951.21 / $10,471.29 / $11,481.54
| Professional | | $2,951.21 | $10,471.29 | $11,481.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7,585.78 / $12,022.64 / $14,454.40
| Facility | | $7,585.78 | $12,022.64 | $14,454.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $95.50 / $2,187.76 / $7,079.46
| Professional | | $95.50 | $2,187.76 | $7,079.46 |