- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,691.53 / $4,786.30 / $8,912.51
| Facility | | $2,691.53 | $4,786.30 | $8,912.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $616.60 / $741.31 / $2,570.40
| Professional | | $616.60 | $741.31 | $2,570.40 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,513.56 / $6,456.54 / $38,018.94
| Facility | | $1,513.56 | $6,456.54 | $38,018.94 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $489.78 / $912.01 / $2,630.27
| Professional | | $489.78 | $912.01 | $2,630.27 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $23,988.33 / $27,542.29 / $36,307.81
| Facility | | $23,988.33 | $27,542.29 | $36,307.81 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7,762.47 / $15,848.93 / $21,877.62
| Facility | | $7,762.47 | $15,848.93 | $21,877.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $912.01 / $1,348.96 / $1,949.84
| Professional | | $912.01 | $1,348.96 | $1,949.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $346.74 / $724.44 / $4,265.80
| Facility | | $346.74 | $724.44 | $4,265.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $338.84 / $616.60 / $912.01
| Professional | | $338.84 | $616.60 | $912.01 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,073.80 / $7,762.47 / $17,782.79
| Facility | | $4,073.80 | $7,762.47 | $17,782.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $588.84 / $1,047.13 / $2,041.74
| Professional | | $588.84 | $1,047.13 | $2,041.74 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $26,302.68 / $26,302.68 / $26,302.68
| Facility | | $26,302.68 | $26,302.68 | $26,302.68 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,513.56 / $6,456.54 / $38,018.94
| Facility | | $1,513.56 | $6,456.54 | $38,018.94 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $489.78 / $912.01 / $2,630.27
| Professional | | $489.78 | $912.01 | $2,630.27 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,754.23 / $7,762.47 / $35,481.34
| Facility | | $2,754.23 | $7,762.47 | $35,481.34 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $691.83 / $1,148.15 / $2,951.21
| Professional | | $691.83 | $1,148.15 | $2,951.21 |