- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9,772.37 / $12,022.64 / $34,673.69
| Facility | | $9,772.37 | $12,022.64 | $34,673.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,454.71 / $7,244.36 / $12,882.50
| Professional | | $2,454.71 | $7,244.36 | $12,882.50 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12,589.25 / $12,589.25 / $22,387.21
| Facility | | $12,589.25 | $12,589.25 | $22,387.21 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4,365.16 / $8,511.38 / $13,803.84
| Professional | | $4,365.16 | $8,511.38 | $13,803.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8,511.38 / $16,982.44 / $20,417.38
| Professional | | $8,511.38 | $16,982.44 | $20,417.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7,585.78 / $7,762.47 / $13,489.63
| Facility | | $7,585.78 | $7,762.47 | $13,489.63 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7,244.36 / $9,332.54 / $11,481.54
| Professional | | $7,244.36 | $9,332.54 | $11,481.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7,762.47 / $7,762.47 / $15,488.17
| Facility | | $7,762.47 | $7,762.47 | $15,488.17 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7,762.47 / $7,762.47 / $9,332.54
| Professional | | $7,762.47 | $7,762.47 | $9,332.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7,585.78 / $10,715.19 / $22,387.21
| Facility | | $7,585.78 | $10,715.19 | $22,387.21 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7,762.47 / $9,332.54 / $11,481.54
| Professional | | $7,762.47 | $9,332.54 | $11,481.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11,748.98 / $22,908.68 / $30,199.52
| Facility | | $11,748.98 | $22,908.68 | $30,199.52 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6,025.60 / $6,606.93 / $9,332.54
| Professional | | $6,025.60 | $6,606.93 | $9,332.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9,332.54 / $11,748.98 / $12,302.69
| Facility | | $9,332.54 | $11,748.98 | $12,302.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,235.94 / $3,235.94 / $9,332.54
| Professional | | $3,235.94 | $3,235.94 | $9,332.54 |