- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,011.87 / $16,218.10 / $22,387.21
| Facility | | $5,011.87 | $16,218.10 | $22,387.21 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4,786.30 / $6,165.95 / $13,182.57
| Professional | | $4,786.30 | $6,165.95 | $13,182.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,370.32 / $8,128.31 / $23,442.29
| Facility | | $5,370.32 | $8,128.31 | $23,442.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4,365.16 / $7,244.36 / $20,892.96
| Professional | | $4,365.16 | $7,244.36 | $20,892.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7,244.36 / $8,912.51 / $14,454.40
| Facility | | $7,244.36 | $8,912.51 | $14,454.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6,760.83 / $6,760.83 / $6,760.83
| Professional | | $6,760.83 | $6,760.83 | $6,760.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,786.30 / $5,623.41 / $11,481.54
| Facility | | $4,786.30 | $5,623.41 | $11,481.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4,073.80 / $7,762.47 / $14,454.40
| Professional | | $4,073.80 | $7,762.47 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,995.26 / $7,585.78 / $41,686.94
| Facility | | $1,995.26 | $7,585.78 | $41,686.94 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10,471.29 / $10,471.29 / $12,302.69
| Professional | | $10,471.29 | $10,471.29 | $12,302.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7,244.36 / $7,244.36 / $11,481.54
| Professional | | $7,244.36 | $7,244.36 | $11,481.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,370.32 / $8,128.31 / $23,442.29
| Facility | | $5,370.32 | $8,128.31 | $23,442.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4,365.16 / $7,244.36 / $20,892.96
| Professional | | $4,365.16 | $7,244.36 | $20,892.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,365.16 / $7,244.36 / $8,709.64
| Facility | | $4,365.16 | $7,244.36 | $8,709.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4,365.16 / $7,244.36 / $11,748.98
| Professional | | $4,365.16 | $7,244.36 | $11,748.98 |