- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,248.07 / $5,754.40 / $6,309.57
| Facility | | $5,248.07 | $5,754.40 | $6,309.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,630.27 / $3,715.35 / $5,754.40
| Professional | | $2,630.27 | $3,715.35 | $5,754.40 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,897.79 / $4,897.79 / $8,317.64
| Facility | | $4,897.79 | $4,897.79 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4,897.79 / $8,709.64 / $10,964.78
| Professional | | $4,897.79 | $8,709.64 | $10,964.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6,165.95 / $8,709.64 / $10,471.29
| Professional | | $6,165.95 | $8,709.64 | $10,471.29 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,011.87 / $9,332.54 / $33,113.11
| Facility | | $5,011.87 | $9,332.54 | $33,113.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,467.37 / $4,677.35 / $12,302.69
| Professional | | $3,467.37 | $4,677.35 | $12,302.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8,128.31 / $8,317.64 / $9,549.93
| Professional | | $8,128.31 | $8,317.64 | $9,549.93 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8,317.64 / $8,317.64 / $8,317.64
| Facility | | $8,317.64 | $8,317.64 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7,079.46 / $12,302.69 / $12,302.69
| Professional | | $7,079.46 | $12,302.69 | $12,302.69 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,019.95 / $7,413.10 / $16,218.10
| Facility | | $3,019.95 | $7,413.10 | $16,218.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,388.44 / $3,890.45 / $6,918.31
| Professional | | $3,388.44 | $3,890.45 | $6,918.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5,623.41 / $7,244.36 / $7,244.36
| Professional | | $5,623.41 | $7,244.36 | $7,244.36 |