- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,290.87 / $6,025.60 / $15,488.17
| Facility | | $2,290.87 | $6,025.60 | $15,488.17 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,949.84 / $2,570.40 / $3,890.45
| Professional | | $1,949.84 | $2,570.40 | $3,890.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $5.50 / $2,187.76
| Professional | | $5.01 | $5.50 | $2,187.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,290.87 / $2,884.03 / $4,466.84
| Professional | | $2,290.87 | $2,884.03 | $4,466.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,862.09 / $1,862.09 / $3,235.94
| Facility | | $1,862.09 | $1,862.09 | $3,235.94 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,995.26 / $7,079.46 / $14,125.38
| Facility | | $1,995.26 | $7,079.46 | $14,125.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,659.59 / $3,090.30 / $5,888.44
| Professional | | $1,659.59 | $3,090.30 | $5,888.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15,488.17 / $15,488.17 / $15,488.17
| Facility | | $15,488.17 | $15,488.17 | $15,488.17 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16,218.10 / $24,547.09 / $24,547.09
| Professional | | $16,218.10 | $24,547.09 | $24,547.09 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,290.87 / $3,311.31 / $8,912.51
| Facility | | $2,290.87 | $3,311.31 | $8,912.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,548.82 / $2,754.23 / $4,897.79
| Professional | | $1,548.82 | $2,754.23 | $4,897.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,235.94 / $3,467.37 / $6,918.31
| Professional | | $3,235.94 | $3,467.37 | $6,918.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,238.72 / $3,388.44 / $10,471.29
| Facility | | $2,238.72 | $3,388.44 | $10,471.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,659.59 / $3,311.31 / $5,888.44
| Professional | | $1,659.59 | $3,311.31 | $5,888.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,202.26 / $3,235.94 / $3,890.45
| Facility | | $1,202.26 | $3,235.94 | $3,890.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,202.26 / $1,348.96 / $2,818.38
| Professional | | $1,202.26 | $1,348.96 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,258.93 / $2,238.72 / $3,235.94
| Professional | | $1,258.93 | $2,238.72 | $3,235.94 |