- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,584.89 / $2,290.87 / $3,630.78
| Facility | | $1,584.89 | $2,290.87 | $3,630.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $323.59 / $933.25 / $1,621.81
| Professional | | $323.59 | $933.25 | $1,621.81 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,511.89 / $3,090.30 / $3,162.28
| Facility | | $2,511.89 | $3,090.30 | $3,162.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $537.03 / $537.03 / $4,677.35
| Professional | | $537.03 | $537.03 | $4,677.35 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,162.28 / $3,715.35 / $5,888.44
| Facility | | $3,162.28 | $3,715.35 | $5,888.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,318.26 / $1,995.26 / $3,630.78
| Professional | | $1,318.26 | $1,995.26 | $3,630.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,288.25 / $4,897.79 / $7,413.10
| Facility | | $1,288.25 | $4,897.79 | $7,413.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6,918.31 / $6,918.31 / $7,762.47
| Professional | | $6,918.31 | $6,918.31 | $7,762.47 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,047.13 / $1,479.11 / $4,073.80
| Facility | | $1,047.13 | $1,479.11 | $4,073.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $524.81 / $691.83 / $3,548.13
| Professional | | $524.81 | $691.83 | $3,548.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $54.95 / $70.79 / $602.56
| Professional | | $54.95 | $70.79 | $602.56 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,258.93 / $1,380.38 / $3,311.31
| Facility | | $1,258.93 | $1,380.38 | $3,311.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,148.15 / $1,862.09 / $3,311.31
| Professional | | $1,148.15 | $1,862.09 | $3,311.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,041.74 / $2,754.23 / $3,981.07
| Professional | | $2,041.74 | $2,754.23 | $3,981.07 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,715.35 / $5,495.41 / $5,495.41
| Facility | | $3,715.35 | $5,495.41 | $5,495.41 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,380.38 / $5,754.40 / $5,754.40
| Professional | | $1,380.38 | $5,754.40 | $5,754.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,148.15 / $1,148.15 / $2,454.71
| Professional | | $1,148.15 | $1,148.15 | $2,454.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,148.15 / $1,148.15 / $6,456.54
| Professional | | $1,148.15 | $1,148.15 | $6,456.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $416.87 / $933.25 / $2,511.89
| Facility | | $416.87 | $933.25 | $2,511.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $489.78 / $691.83 / $1,905.46
| Professional | | $489.78 | $691.83 | $1,905.46 |