- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,128.61 / $12,882.50 / $39,810.72
| Facility | | $5,128.61 | $12,882.50 | $39,810.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,454.71 / $6,025.60 / $9,332.54
| Professional | | $2,454.71 | $6,025.60 | $9,332.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $5.50 / $5,248.07
| Professional | | $5.01 | $5.50 | $5,248.07 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $79.43 / $7,762.47 / $7,762.47
| Facility | | $79.43 | $7,762.47 | $7,762.47 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,128.61 / $15,848.93 / $34,673.69
| Facility | | $5,128.61 | $15,848.93 | $34,673.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,981.07 / $7,943.28 / $13,182.57
| Professional | | $3,981.07 | $7,943.28 | $13,182.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $37,153.52 / $37,153.52 / $37,153.52
| Facility | | $37,153.52 | $37,153.52 | $37,153.52 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $38,904.51 / $58,884.37 / $58,884.37
| Professional | | $38,904.51 | $58,884.37 | $58,884.37 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,128.61 / $7,762.47 / $14,454.40
| Facility | | $5,128.61 | $7,762.47 | $14,454.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $6,606.93 / $11,748.98
| Professional | | $7.94 | $6,606.93 | $11,748.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7,762.47 / $8,317.64 / $16,595.87
| Professional | | $7,762.47 | $8,317.64 | $16,595.87 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,897.79 / $7,762.47 / $21,379.62
| Facility | | $4,897.79 | $7,762.47 | $21,379.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4,897.79 / $8,511.38 / $13,489.63
| Professional | | $4,897.79 | $8,511.38 | $13,489.63 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,235.94 / $7,762.47 / $9,332.54
| Facility | | $3,235.94 | $7,762.47 | $9,332.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,235.94 / $3,235.94 / $7,762.47
| Professional | | $3,235.94 | $3,235.94 | $7,762.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $316.23 / $5,370.32 / $7,762.47
| Professional | | $316.23 | $5,370.32 | $7,762.47 |