- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,951.21 / $5,495.41 / $6,760.83
| Facility | | $2,951.21 | $5,495.41 | $6,760.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,698.24 / $2,089.30 / $3,090.30
| Professional | | $1,698.24 | $2,089.30 | $3,090.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,248.07 / $6,606.93 / $6,760.83
| Facility | | $5,248.07 | $6,606.93 | $6,760.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $977.24 / $977.24 / $9,772.37
| Professional | | $977.24 | $977.24 | $9,772.37 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,760.83 / $7,943.28 / $12,589.25
| Facility | | $6,760.83 | $7,943.28 | $12,589.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,778.28 / $3,715.35 / $7,585.78
| Professional | | $1,778.28 | $3,715.35 | $7,585.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,691.53 / $10,232.93 / $15,488.17
| Facility | | $2,691.53 | $10,232.93 | $15,488.17 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14,791.08 / $14,791.08 / $16,218.10
| Professional | | $14,791.08 | $14,791.08 | $16,218.10 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,187.76 / $3,162.28 / $8,511.38
| Facility | | $2,187.76 | $3,162.28 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,096.48 / $1,479.11 / $7,585.78
| Professional | | $1,096.48 | $1,479.11 | $7,585.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $50.12 / $64.57 / $2,454.71
| Professional | | $50.12 | $64.57 | $2,454.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,630.27 / $2,951.21 / $7,079.46
| Facility | | $2,630.27 | $2,951.21 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,454.71 / $3,890.45 / $6,918.31
| Professional | | $2,454.71 | $3,890.45 | $6,918.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,981.07 / $5,754.40 / $8,128.31
| Professional | | $3,981.07 | $5,754.40 | $8,128.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,897.79 / $11,748.98 / $11,748.98
| Facility | | $4,897.79 | $11,748.98 | $11,748.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,174.90 / $12,302.69 / $12,302.69
| Professional | | $1,174.90 | $12,302.69 | $12,302.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,454.71 / $2,454.71 / $5,248.07
| Professional | | $2,454.71 | $2,454.71 | $5,248.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,454.71 / $7,943.28 / $13,489.63
| Professional | | $2,454.71 | $7,943.28 | $13,489.63 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $891.25 / $1,949.84 / $5,370.32
| Facility | | $891.25 | $1,949.84 | $5,370.32 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,023.29 / $1,479.11 / $3,715.35
| Professional | | $1,023.29 | $1,479.11 | $3,715.35 |