- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,047.13 / $4,168.69 / $14,454.40
| Facility | | $1,047.13 | $4,168.69 | $14,454.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $616.60 / $776.25 / $1,288.25
| Professional | | $616.60 | $776.25 | $1,288.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $537.03 / $630.96 / $676.08
| Professional | | $537.03 | $630.96 | $676.08 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,073.80 / $6,918.31 / $13,803.84
| Facility | | $4,073.80 | $6,918.31 | $13,803.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $549.54 / $660.69 / $1,047.13
| Professional | | $549.54 | $660.69 | $1,047.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,951.21 / $5,754.40 / $9,549.93
| Facility | | $2,951.21 | $5,754.40 | $9,549.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $676.08 / $933.25 / $1,122.02
| Professional | | $676.08 | $933.25 | $1,122.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $575.44 / $5,495.41 / $5,495.41
| Facility | | $575.44 | $5,495.41 | $5,495.41 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,677.35 / $4,677.35 / $4,786.30
| Facility | | $4,677.35 | $4,677.35 | $4,786.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $676.08 / $870.96 / $1,412.54
| Professional | | $676.08 | $870.96 | $1,412.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $54.95 / $56.23 / $22,387.21
| Facility | | $54.95 | $56.23 | $22,387.21 |
- Facility/Professional
- Facility
- Modifier
- 53
- Typical Low / Median / Typical High
- $4,466.84 / $4,466.84 / $4,466.84
| Facility | 53 | $4,466.84 | $4,466.84 | $4,466.84 |
- Facility/Professional
- Facility
- Modifier
- 54
- Typical Low / Median / Typical High
- $15,848.93 / $15,848.93 / $15,848.93
| Facility | 54 | $15,848.93 | $15,848.93 | $15,848.93 |
- Facility/Professional
- Facility
- Modifier
- 55
- Typical Low / Median / Typical High
- $3,388.44 / $3,388.44 / $3,388.44
| Facility | 55 | $3,388.44 | $3,388.44 | $3,388.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4,897.79 / $5,623.41 / $5,623.41
| Professional | | $4,897.79 | $5,623.41 | $5,623.41 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $645.65 / $1,318.26 / $7,943.28
| Facility | | $645.65 | $1,318.26 | $7,943.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $645.65 / $831.76 / $1,380.38
| Professional | | $645.65 | $831.76 | $1,380.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $407.38
| Professional | | $32.36 | $33.11 | $407.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $575.44 / $1,023.29 / $1,318.26
| Professional | | $575.44 | $1,023.29 | $1,318.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $588.84 / $741.31 / $1,288.25
| Facility | | $588.84 | $741.31 | $1,288.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $676.08 / $870.96 / $1,380.38
| Professional | | $676.08 | $870.96 | $1,380.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,187.76 / $6,025.60 / $11,481.54
| Facility | | $2,187.76 | $6,025.60 | $11,481.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $537.03 / $741.31 / $1,122.02
| Professional | | $537.03 | $741.31 | $1,122.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $562.34 / $588.84 / $588.84
| Professional | | $562.34 | $588.84 | $588.84 |