- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,905.46 / $4,265.80 / $6,025.60
| Facility | | $1,905.46 | $4,265.80 | $6,025.60 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,187.76 / $2,818.38 / $4,897.79
| Professional | | $2,187.76 | $2,818.38 | $4,897.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,370.32 / $5,370.32 / $10,715.19
| Facility | | $5,370.32 | $5,370.32 | $10,715.19 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,162.28 / $3,162.28 / $9,120.11
| Professional | | $3,162.28 | $3,162.28 | $9,120.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,073.80 / $4,365.16 / $4,365.16
| Facility | | $4,073.80 | $4,365.16 | $4,365.16 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4,365.16 / $4,365.16 / $4,365.16
| Professional | | $4,365.16 | $4,365.16 | $4,365.16 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,715.35 / $3,715.35 / $53,703.18
| Facility | | $3,715.35 | $3,715.35 | $53,703.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,754.23 / $2,754.23 / $6,760.83
| Professional | | $2,754.23 | $2,754.23 | $6,760.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,370.32 / $8,912.51 / $20,417.38
| Facility | | $5,370.32 | $8,912.51 | $20,417.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,311.31 / $5,370.32 / $10,232.93
| Professional | | $3,311.31 | $5,370.32 | $10,232.93 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,754.23 / $2,754.23 / $2,884.03
| Facility | | $2,754.23 | $2,754.23 | $2,884.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,754.23 / $3,162.28 / $3,311.31
| Professional | | $2,754.23 | $3,162.28 | $3,311.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,888.44 / $50,118.72 / $75,857.76
| Facility | | $5,888.44 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,467.37 / $5,128.61 / $5,128.61
| Professional | | $3,467.37 | $5,128.61 | $5,128.61 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,187.76 / $3,890.45 / $14,791.08
| Facility | | $2,187.76 | $3,890.45 | $14,791.08 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,737.80 / $3,467.37 / $8,912.51
| Professional | | $1,737.80 | $3,467.37 | $8,912.51 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,754.23 / $3,162.28 / $3,235.94
| Facility | | $2,754.23 | $3,162.28 | $3,235.94 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,754.23 / $3,162.28 / $3,311.31
| Professional | | $2,754.23 | $3,162.28 | $3,311.31 |