- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,754.40 / $7,762.47 / $23,988.33
| Facility | | $5,754.40 | $7,762.47 | $23,988.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4,786.30 / $5,754.40 / $8,912.51
| Professional | | $4,786.30 | $5,754.40 | $8,912.51 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15,848.93 / $15,848.93 / $22,908.68
| Facility | | $15,848.93 | $15,848.93 | $22,908.68 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6,165.95 / $7,244.36 / $12,882.50
| Professional | | $6,165.95 | $7,244.36 | $12,882.50 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,495.41 / $15,848.93 / $32,359.37
| Facility | | $5,495.41 | $15,848.93 | $32,359.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,311.31 / $3,630.78 / $10,964.78
| Professional | | $3,311.31 | $3,630.78 | $10,964.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,623.41 / $6,456.54 / $10,471.29
| Facility | | $5,623.41 | $6,456.54 | $10,471.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4,677.35 / $4,677.35 / $4,677.35
| Professional | | $4,677.35 | $4,677.35 | $4,677.35 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7,244.36 / $7,244.36 / $7,585.78
| Professional | | $7,244.36 | $7,244.36 | $7,585.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,365.16 / $8,511.38 / $8,709.64
| Facility | | $4,365.16 | $8,511.38 | $8,709.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,019.95 / $4,365.16 / $8,317.64
| Professional | | $3,019.95 | $4,365.16 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $33,884.42 / $33,884.42 / $33,884.42
| Facility | | $33,884.42 | $33,884.42 | $33,884.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $35,481.34 / $35,481.34 / $53,703.18
| Professional | | $35,481.34 | $35,481.34 | $53,703.18 |