- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,951.21 / $7,079.46 / $26,302.68
| Facility | | $2,951.21 | $7,079.46 | $26,302.68 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,691.53 / $3,801.89 / $7,943.28
| Professional | | $2,691.53 | $3,801.89 | $7,943.28 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,786.30 / $7,079.46 / $9,549.93
| Facility | | $4,786.30 | $7,079.46 | $9,549.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4,073.80 / $4,570.88 / $6,309.57
| Professional | | $4,073.80 | $4,570.88 | $6,309.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,073.80 / $7,762.47 / $12,302.69
| Facility | | $4,073.80 | $7,762.47 | $12,302.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,398.83 / $5,370.32 / $6,918.31
| Professional | | $2,398.83 | $5,370.32 | $6,918.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,786.30 / $6,025.60 / $14,791.08
| Facility | | $4,786.30 | $6,025.60 | $14,791.08 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4,786.30 / $6,025.60 / $13,489.63
| Professional | | $4,786.30 | $6,025.60 | $13,489.63 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $75.86 / $954.99 / $4,570.88
| Professional | | $75.86 | $954.99 | $4,570.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,786.30 / $4,786.30 / $9,549.93
| Facility | | $4,786.30 | $4,786.30 | $9,549.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4,786.30 / $4,786.30 / $5,754.40
| Professional | | $4,786.30 | $4,786.30 | $5,754.40 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,786.30 / $7,585.78 / $14,791.08
| Facility | | $4,786.30 | $7,585.78 | $14,791.08 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4,265.80 / $4,265.80 / $5,888.44
| Professional | | $4,265.80 | $4,265.80 | $5,888.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,495.41 / $7,244.36 / $12,589.25
| Facility | | $5,495.41 | $7,244.36 | $12,589.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,890.45 / $4,365.16 / $6,309.57
| Professional | | $3,890.45 | $4,365.16 | $6,309.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,265.80 / $5,754.40 / $5,754.40
| Facility | | $4,265.80 | $5,754.40 | $5,754.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,995.26 / $1,995.26 / $5,370.32
| Professional | | $1,995.26 | $1,995.26 | $5,370.32 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,137.96 / $2,454.71 / $8,511.38
| Professional | | $2,137.96 | $2,454.71 | $8,511.38 |