- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,949.84 / $2,630.27 / $14,454.40
| Facility | | $1,949.84 | $2,630.27 | $14,454.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,148.15 / $1,479.11 / $2,630.27
| Professional | | $1,148.15 | $1,479.11 | $2,630.27 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,011.87 / $8,317.64 / $14,125.38
| Facility | | $5,011.87 | $8,317.64 | $14,125.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,148.15 / $2,511.89 / $6,309.57
| Professional | | $1,148.15 | $2,511.89 | $6,309.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,388.44 / $3,981.07 / $6,309.57
| Facility | | $3,388.44 | $3,981.07 | $6,309.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,819.70 / $4,570.88 / $6,309.57
| Professional | | $1,819.70 | $4,570.88 | $6,309.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,230.27 / $2,754.23 / $4,786.30
| Facility | | $1,230.27 | $2,754.23 | $4,786.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,290.87 / $3,162.28 / $3,715.35
| Professional | | $2,290.87 | $3,162.28 | $3,715.35 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,380.38 / $4,786.30 / $11,481.54
| Facility | | $1,380.38 | $4,786.30 | $11,481.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,230.27 / $2,398.83 / $9,549.93
| Professional | | $1,230.27 | $2,398.83 | $9,549.93 |
- 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
- $2,454.71 / $8,511.38 / $9,120.11
| Facility | | $2,454.71 | $8,511.38 | $9,120.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,548.82 / $3,235.94 / $5,495.41
| Professional | | $1,548.82 | $3,235.94 | $5,495.41 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,230.27 / $2,630.27 / $3,890.45
| Professional | | $1,230.27 | $2,630.27 | $3,890.45 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,165.95 / $8,912.51 / $8,912.51
| Facility | | $6,165.95 | $8,912.51 | $8,912.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,290.87 / $6,025.60 / $9,120.11
| Professional | | $2,290.87 | $6,025.60 | $9,120.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6,456.54 / $6,456.54 / $6,456.54
| Professional | | $6,456.54 | $6,456.54 | $6,456.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,128.61 / $5,128.61 / $5,128.61
| Facility | | $5,128.61 | $5,128.61 | $5,128.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4,677.35 / $12,302.69 / $12,302.69
| Professional | | $4,677.35 | $12,302.69 | $12,302.69 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,309.57 / $10,232.93 / $12,022.64
| Facility | | $6,309.57 | $10,232.93 | $12,022.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,122.02 / $2,089.30 / $5,248.07
| Professional | | $1,122.02 | $2,089.30 | $5,248.07 |