- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,235.94 / $5,623.41 / $6,456.54
| Facility | | $3,235.94 | $5,623.41 | $6,456.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,041.74 / $2,818.38 / $5,495.41
| Professional | | $2,041.74 | $2,818.38 | $5,495.41 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,311.31 / $3,311.31 / $11,748.98
| Facility | | $3,311.31 | $3,311.31 | $11,748.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $851.14 / $2,187.76 / $5,888.44
| Professional | | $851.14 | $2,187.76 | $5,888.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,570.88 / $4,897.79 / $8,709.64
| Facility | | $4,570.88 | $4,897.79 | $8,709.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,344.23 / $3,311.31 / $3,715.35
| Professional | | $2,344.23 | $3,311.31 | $3,715.35 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,388.44 / $6,309.57 / $8,128.31
| Facility | | $3,388.44 | $6,309.57 | $8,128.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,513.56 / $3,162.28 / $4,786.30
| Professional | | $1,513.56 | $3,162.28 | $4,786.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,691.53 / $4,168.69 / $15,848.93
| Facility | | $2,691.53 | $4,168.69 | $15,848.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,380.38 / $1,995.26 / $16,595.87
| Professional | | $1,380.38 | $1,995.26 | $16,595.87 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,380.38 / $3,311.31 / $3,981.07
| Facility | | $1,380.38 | $3,311.31 | $3,981.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,380.38 / $1,995.26 / $3,981.07
| Professional | | $1,380.38 | $1,995.26 | $3,981.07 |