- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,023.29 / $2,511.89 / $14,454.40
| Facility | | $1,023.29 | $2,511.89 | $14,454.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $602.56 / $794.33 / $1,698.24
| Professional | | $602.56 | $794.33 | $1,698.24 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,606.93 / $10,964.78 / $17,378.01
| Facility | | $6,606.93 | $10,964.78 | $17,378.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $676.08 / $1,318.26 / $3,235.94
| Professional | | $676.08 | $1,318.26 | $3,235.94 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,819.70 / $2,089.30 / $3,388.44
| Facility | | $1,819.70 | $2,089.30 | $3,388.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $977.24 / $2,238.72 / $2,511.89
| Professional | | $977.24 | $2,238.72 | $2,511.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $758.58 / $6,760.83 / $13,489.63
| Facility | | $758.58 | $6,760.83 | $13,489.63 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,258.93 / $1,698.24 / $1,949.84
| Professional | | $1,258.93 | $1,698.24 | $1,949.84 |
- Facility/Professional
- Professional
- Modifier
- 55
- Typical Low / Median / Typical High
- $251.19 / $338.84 / $398.11
| Professional | 55 | $251.19 | $338.84 | $398.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $758.58 / $7,585.78 / $15,848.93
| Facility | | $758.58 | $7,585.78 | $15,848.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $707.95 / $1,348.96 / $5,128.61
| Professional | | $707.95 | $1,348.96 | $5,128.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $70.79
| Professional | | $32.36 | $33.11 | $70.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8,317.64 / $9,772.37 / $15,848.93
| Facility | | $8,317.64 | $9,772.37 | $15,848.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $851.14 / $933.25 / $1,737.80
| Professional | | $851.14 | $933.25 | $1,737.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $776.25 / $1,348.96 / $2,041.74
| Professional | | $776.25 | $1,348.96 | $2,041.74 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14,454.40 / $21,379.62 / $21,379.62
| Facility | | $14,454.40 | $21,379.62 | $21,379.62 |
- Facility/Professional
- Facility
- Modifier
- 53
- Typical Low / Median / Typical High
- $2,884.03 / $4,265.80 / $4,265.80
| Facility | 53 | $2,884.03 | $4,265.80 | $4,265.80 |
- Facility/Professional
- Facility
- Modifier
- 54
- Typical Low / Median / Typical High
- $10,232.93 / $14,791.08 / $14,791.08
| Facility | 54 | $10,232.93 | $14,791.08 | $14,791.08 |
- Facility/Professional
- Facility
- Modifier
- 55
- Typical Low / Median / Typical High
- $2,187.76 / $3,162.28 / $3,162.28
| Facility | 55 | $2,187.76 | $3,162.28 | $3,162.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,096.48 / $2,818.38 / $4,897.79
| Professional | | $1,096.48 | $2,818.38 | $4,897.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,162.28 / $3,162.28 / $3,162.28
| Professional | | $3,162.28 | $3,162.28 | $3,162.28 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12,022.64 / $12,022.64 / $12,022.64
| Facility | | $12,022.64 | $12,022.64 | $12,022.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,570.40 / $6,606.93 / $6,606.93
| Professional | | $2,570.40 | $6,606.93 | $6,606.93 |
- 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 / $1,862.09 / $4,677.35
| Professional | | $95.50 | $1,862.09 | $4,677.35 |