- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,981.07 / $7,943.28 / $9,549.93
| Facility | | $3,981.07 | $7,943.28 | $9,549.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,019.95 / $4,073.80 / $8,709.64
| Professional | | $3,019.95 | $4,073.80 | $8,709.64 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,786.30 / $4,786.30 / $16,595.87
| Facility | | $4,786.30 | $4,786.30 | $16,595.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $851.14 / $3,162.28 / $8,511.38
| Professional | | $851.14 | $3,162.28 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,606.93 / $7,079.46 / $12,302.69
| Facility | | $6,606.93 | $7,079.46 | $12,302.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,311.31 / $4,786.30 / $5,370.32
| Professional | | $3,311.31 | $4,786.30 | $5,370.32 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,897.79 / $8,912.51 / $11,748.98
| Facility | | $4,897.79 | $8,912.51 | $11,748.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,187.76 / $4,570.88 / $6,918.31
| Professional | | $2,187.76 | $4,570.88 | $6,918.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,890.45 / $6,025.60 / $22,908.68
| Facility | | $3,890.45 | $6,025.60 | $22,908.68 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,995.26 / $2,884.03 / $23,988.33
| Professional | | $1,995.26 | $2,884.03 | $23,988.33 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,995.26 / $4,786.30 / $5,754.40
| Facility | | $1,995.26 | $4,786.30 | $5,754.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,995.26 / $2,884.03 / $5,754.40
| Professional | | $1,995.26 | $2,884.03 | $5,754.40 |