- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,513.56 / $5,888.44 / $16,595.87
| Facility | | $1,513.56 | $5,888.44 | $16,595.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,230.27 / $1,513.56 / $2,398.83
| Professional | | $1,230.27 | $1,513.56 | $2,398.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16,595.87 / $18,620.87 / $18,620.87
| Facility | | $16,595.87 | $18,620.87 | $18,620.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,230.27 / $1,621.81 / $2,290.87
| Professional | | $1,230.27 | $1,621.81 | $2,290.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,513.56 / $29,512.09 / $43,651.58
| Professional | | $1,513.56 | $29,512.09 | $43,651.58 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8,511.38 / $16,218.10 / $46,773.51
| Facility | | $8,511.38 | $16,218.10 | $46,773.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,348.96 / $1,737.80 / $3,311.31
| Professional | | $1,348.96 | $1,737.80 | $3,311.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,096.48 / $1,318.26 / $1,621.81
| Professional | | $1,096.48 | $1,318.26 | $1,621.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,584.89 / $1,995.26 / $2,454.71
| Professional | | $1,584.89 | $1,995.26 | $2,454.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,230.27 / $1,862.09 / $2,630.27
| Facility | | $1,230.27 | $1,862.09 | $2,630.27 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,230.27 / $1,778.28 / $34,673.69
| Facility | | $1,230.27 | $1,778.28 | $34,673.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,230.27 / $1,778.28 / $34,673.69
| Professional | | $1,230.27 | $1,778.28 | $34,673.69 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13,182.57 / $22,387.21 / $45,708.82
| Facility | | $13,182.57 | $22,387.21 | $45,708.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,174.90 / $1,778.28 / $2,754.23
| Professional | | $1,174.90 | $1,778.28 | $2,754.23 |