- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,918.31 / $12,022.64 / $13,803.84
| Facility | | $6,918.31 | $12,022.64 | $13,803.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4,786.30 / $6,309.57 / $11,748.98
| Professional | | $4,786.30 | $6,309.57 | $11,748.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7,244.36 / $7,244.36 / $25,118.86
| Facility | | $7,244.36 | $7,244.36 | $25,118.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,884.03 / $4,466.84 / $12,882.50
| Professional | | $2,884.03 | $4,466.84 | $12,882.50 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10,000.00 / $10,471.29 / $18,620.87
| Facility | | $10,000.00 | $10,471.29 | $18,620.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5,011.87 / $7,244.36 / $12,302.69
| Professional | | $5,011.87 | $7,244.36 | $12,302.69 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10,232.93 / $14,125.38 / $16,982.44
| Facility | | $10,232.93 | $14,125.38 | $16,982.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,162.28 / $3,801.89 / $10,000.00
| Professional | | $3,162.28 | $3,801.89 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,165.95 / $8,709.64 / $33,884.42
| Facility | | $6,165.95 | $8,709.64 | $33,884.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,019.95 / $4,365.16 / $35,481.34
| Professional | | $3,019.95 | $4,365.16 | $35,481.34 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,019.95 / $7,244.36 / $8,709.64
| Facility | | $3,019.95 | $7,244.36 | $8,709.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,019.95 / $4,365.16 / $9,772.37
| Professional | | $3,019.95 | $4,365.16 | $9,772.37 |