- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,754.23 / $11,481.54 / $42,657.95
| Facility | | $2,754.23 | $11,481.54 | $42,657.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $891.25 / $1,258.93 / $4,466.84
| Professional | | $891.25 | $1,258.93 | $4,466.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $794.33 / $794.33 / $812.83
| Professional | | $794.33 | $794.33 | $812.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,248.07 / $21,877.62 / $39,810.72
| Facility | | $5,248.07 | $21,877.62 | $39,810.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $912.01 / $1,148.15 / $6,606.93
| Professional | | $912.01 | $1,148.15 | $6,606.93 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $24,547.09 / $26,302.68 / $35,481.34
| Facility | | $24,547.09 | $26,302.68 | $35,481.34 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,023.29 / $1,318.26 / $2,089.30
| Professional | | $1,023.29 | $1,318.26 | $2,089.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $870.96 / $3,890.45 / $26,302.68
| Facility | | $870.96 | $3,890.45 | $26,302.68 |
- Facility/Professional
- Facility
- Modifier
- 53
- Typical Low / Median / Typical High
- $407.38 / $407.38 / $5,370.32
| Facility | 53 | $407.38 | $407.38 | $5,370.32 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,023.29 / $1,288.25 / $6,760.83
| Professional | | $1,023.29 | $1,288.25 | $6,760.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7,079.46 / $15,135.61 / $30,902.95
| Facility | | $7,079.46 | $15,135.61 | $30,902.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $954.99 / $1,230.27 / $1,905.46
| Professional | | $954.99 | $1,230.27 | $1,905.46 |