- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,691.53 / $4,677.35 / $9,332.54
| Facility | | $2,691.53 | $4,677.35 | $9,332.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,023.29 / $1,258.93 / $4,466.84
| Professional | | $1,023.29 | $1,258.93 | $4,466.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,454.71 / $6,025.60 / $22,387.21
| Facility | | $2,454.71 | $6,025.60 | $22,387.21 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $851.14 / $1,513.56 / $9,120.11
| Professional | | $851.14 | $1,513.56 | $9,120.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15,135.61 / $17,378.01 / $22,908.68
| Facility | | $15,135.61 | $17,378.01 | $22,908.68 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,995.26 / $9,549.93 / $21,877.62
| Facility | | $1,995.26 | $9,549.93 | $21,877.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,479.11 / $2,187.76 / $3,162.28
| Professional | | $1,479.11 | $2,187.76 | $3,162.28 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $588.84 / $1,202.26 / $2,951.21
| Facility | | $588.84 | $1,202.26 | $2,951.21 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $588.84 / $1,071.52 / $1,584.89
| Professional | | $588.84 | $1,071.52 | $1,584.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,090.30 / $6,918.31 / $15,488.17
| Facility | | $3,090.30 | $6,918.31 | $15,488.17 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,000.00 / $1,737.80 / $3,388.44
| Professional | | $1,000.00 | $1,737.80 | $3,388.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $24,547.09 / $24,547.09 / $24,547.09
| Facility | | $24,547.09 | $24,547.09 | $24,547.09 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,454.71 / $6,025.60 / $22,387.21
| Facility | | $2,454.71 | $6,025.60 | $22,387.21 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $851.14 / $1,513.56 / $9,120.11
| Professional | | $851.14 | $1,513.56 | $9,120.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,570.40 / $6,165.95 / $20,892.96
| Facility | | $2,570.40 | $6,165.95 | $20,892.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,174.90 / $1,778.28 / $4,897.79
| Professional | | $1,174.90 | $1,778.28 | $4,897.79 |