- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,659.59 / $26,302.68 / $56,234.13
| Facility | | $1,659.59 | $26,302.68 | $56,234.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $831.76 / $1,230.27 / $4,073.80
| Professional | | $831.76 | $1,230.27 | $4,073.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,096.48 / $1,412.54 / $2,238.72
| Professional | | $1,096.48 | $1,412.54 | $2,238.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,288.25 / $2,238.72 / $3,090.30
| Professional | | $1,288.25 | $2,238.72 | $3,090.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $42,657.95 / $44,668.36 / $44,668.36
| Facility | | $42,657.95 | $44,668.36 | $44,668.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,202.26 / $1,621.81 / $2,884.03
| Professional | | $1,202.26 | $1,621.81 | $2,884.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $933.25 / $1,174.90 / $1,862.09
| Facility | | $933.25 | $1,174.90 | $1,862.09 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12,302.69 / $26,302.68 / $53,703.18
| Facility | | $12,302.69 | $26,302.68 | $53,703.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,096.48 / $1,584.89 / $2,691.53
| Professional | | $1,096.48 | $1,584.89 | $2,691.53 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $114,815.36 / $114,815.36 / $114,815.36
| Facility | | $114,815.36 | $114,815.36 | $114,815.36 |
- Facility/Professional
- Facility
- Modifier
- 53
- Typical Low / Median / Typical High
- $22,908.68 / $22,908.68 / $22,908.68
| Facility | 53 | $22,908.68 | $22,908.68 | $22,908.68 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6,760.83 / $7,943.28 / $7,943.28
| Professional | | $6,760.83 | $7,943.28 | $7,943.28 |