- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,760.83 / $12,589.25 / $19,952.62
| Facility | | $6,760.83 | $12,589.25 | $19,952.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,890.45 / $6,165.95 / $13,182.57
| Professional | | $3,890.45 | $6,165.95 | $13,182.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7,244.36 / $7,244.36 / $18,620.87
| Facility | | $7,244.36 | $7,244.36 | $18,620.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,884.03 / $2,884.03 / $13,803.84
| Professional | | $2,884.03 | $2,884.03 | $13,803.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,365.16 / $7,244.36 / $7,244.36
| Facility | | $4,365.16 | $7,244.36 | $7,244.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5,248.07 / $7,244.36 / $7,244.36
| Professional | | $5,248.07 | $7,244.36 | $7,244.36 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7,079.46 / $15,488.17 / $18,620.87
| Facility | | $7,079.46 | $15,488.17 | $18,620.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4,466.84 / $9,120.11 / $34,673.69
| Professional | | $4,466.84 | $9,120.11 | $34,673.69 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7,244.36 / $11,748.98 / $27,542.29
| Facility | | $7,244.36 | $11,748.98 | $27,542.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5,011.87 / $6,456.54 / $13,803.84
| Professional | | $5,011.87 | $6,456.54 | $13,803.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6,025.60 / $7,079.46 / $12,882.50
| Professional | | $6,025.60 | $7,079.46 | $12,882.50 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9,332.54 / $13,489.63 / $50,118.72
| Facility | | $9,332.54 | $13,489.63 | $50,118.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7,244.36 / $7,244.36 / $7,413.10
| Professional | | $7,244.36 | $7,244.36 | $7,413.10 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,456.54 / $7,244.36 / $8,912.51
| Facility | | $6,456.54 | $7,244.36 | $8,912.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,019.95 / $5,011.87 / $10,964.78
| Professional | | $3,019.95 | $5,011.87 | $10,964.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,370.32 / $7,585.78 / $9,549.93
| Facility | | $5,370.32 | $7,585.78 | $9,549.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5,370.32 / $7,244.36 / $16,982.44
| Professional | | $5,370.32 | $7,244.36 | $16,982.44 |