- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,047.13 / $6,165.95 / $30,902.95
| Facility | | $1,047.13 | $6,165.95 | $30,902.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $281.84 / $323.59 / $416.87
| Professional | | $281.84 | $323.59 | $416.87 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $23,988.33 / $36,307.81 / $57,543.99
| Facility | | $23,988.33 | $36,307.81 | $57,543.99 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $316.23 / $371.54 / $630.96
| Professional | | $316.23 | $371.54 | $630.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $81.28 / $158.49 / $3,388.44
| Facility | | $81.28 | $158.49 | $3,388.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $323.59 / $446.68 / $616.60
| Professional | | $323.59 | $446.68 | $616.60 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $575.44 / $575.44 / $10,964.78
| Professional | | $575.44 | $575.44 | $10,964.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $117.49 / $117.49 / $117.49
| Facility | | $117.49 | $117.49 | $117.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $363.08 / $363.08 / $741.31
| Professional | | $363.08 | $363.08 | $741.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15,848.93 / $15,848.93 / $15,848.93
| Facility | | $15,848.93 | $15,848.93 | $15,848.93 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $724.44 / $3,981.07 / $8,511.38
| Facility | | $724.44 | $3,981.07 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $281.84 / $331.13 / $575.44
| Professional | | $281.84 | $331.13 | $575.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $426.58 / $446.68 / $446.68
| Professional | | $426.58 | $446.68 | $446.68 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $158.49 / $323.59 / $363.08
| Facility | | $158.49 | $323.59 | $363.08 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $158.49 / $323.59 / $363.08
| Professional | | $158.49 | $323.59 | $363.08 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,454.71 / $6,309.57 / $25,118.86
| Facility | | $2,454.71 | $6,309.57 | $25,118.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $316.23 / $436.52 / $741.31
| Professional | | $316.23 | $436.52 | $741.31 |