- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,466.84 / $10,471.29 / $25,118.86
| Facility | | $4,466.84 | $10,471.29 | $25,118.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $741.31 / $954.99 / $2,290.87
| Professional | | $741.31 | $954.99 | $2,290.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $724.44 / $812.83 / $954.99
| Professional | | $724.44 | $812.83 | $954.99 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,918.31 / $11,481.54 / $18,620.87
| Facility | | $6,918.31 | $11,481.54 | $18,620.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $954.99 / $1,348.96 / $2,884.03
| Professional | | $954.99 | $1,348.96 | $2,884.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $85.11 / $7,943.28 / $16,982.44
| Facility | | $85.11 | $7,943.28 | $16,982.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $870.96 / $1,174.90 / $2,818.38
| Professional | | $870.96 | $1,174.90 | $2,818.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $912.01 / $1,737.80 / $2,344.23
| Facility | | $912.01 | $1,737.80 | $2,344.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $794.33 / $1,148.15 / $2,398.83
| Professional | | $794.33 | $1,148.15 | $2,398.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $501.19 / $912.01 / $1,230.27
| Professional | | $501.19 | $912.01 | $1,230.27 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $724.44 / $933.25 / $1,862.09
| Professional | | $724.44 | $933.25 | $1,862.09 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7,079.46 / $33,884.42 / $33,884.42
| Facility | | $7,079.46 | $33,884.42 | $33,884.42 |
- Facility/Professional
- Facility
- Modifier
- 54
- Typical Low / Median / Typical High
- $4,897.79 / $4,897.79 / $4,897.79
| Facility | 54 | $4,897.79 | $4,897.79 | $4,897.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6,456.54 / $7,413.10 / $7,413.10
| Professional | | $6,456.54 | $7,413.10 | $7,413.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,258.93 / $1,258.93 / $1,258.93
| Professional | | $1,258.93 | $1,258.93 | $1,258.93 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $851.14 / $1,148.15 / $1,862.09
| Facility | | $851.14 | $1,148.15 | $1,862.09 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $794.33 / $1,148.15 / $2,398.83
| Professional | | $794.33 | $1,148.15 | $2,398.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,951.21 / $2,951.21 / $2,951.21
| Professional | | $2,951.21 | $2,951.21 | $2,951.21 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $630.96 / $831.76 / $1,096.48
| Professional | | $630.96 | $831.76 | $1,096.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,630.78 / $7,079.46 / $15,135.61
| Facility | | $3,630.78 | $7,079.46 | $15,135.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $707.95 / $933.25 / $2,187.76
| Professional | | $707.95 | $933.25 | $2,187.76 |