- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,456.54 / $6,760.83 / $7,244.36
| Facility | | $6,456.54 | $6,760.83 | $7,244.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,715.35 / $4,570.88 / $7,413.10
| Professional | | $3,715.35 | $4,570.88 | $7,413.10 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,025.60 / $6,025.60 / $9,772.37
| Facility | | $6,025.60 | $6,025.60 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6,025.60 / $10,000.00 / $12,589.25
| Professional | | $6,025.60 | $10,000.00 | $12,589.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8,128.31 / $9,332.54 / $10,964.78
| Professional | | $8,128.31 | $9,332.54 | $10,964.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,888.44 / $11,220.18 / $40,738.03
| Facility | | $5,888.44 | $11,220.18 | $40,738.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4,073.80 / $5,888.44 / $14,454.40
| Professional | | $4,073.80 | $5,888.44 | $14,454.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9,549.93 / $9,772.37 / $11,748.98
| Professional | | $9,549.93 | $9,772.37 | $11,748.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9,772.37 / $9,772.37 / $9,772.37
| Facility | | $9,772.37 | $9,772.37 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8,912.51 / $14,454.40 / $14,454.40
| Professional | | $8,912.51 | $14,454.40 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,801.89 / $8,912.51 / $20,417.38
| Facility | | $3,801.89 | $8,912.51 | $20,417.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,981.07 / $4,570.88 / $8,317.64
| Professional | | $3,981.07 | $4,570.88 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6,760.83 / $8,511.38 / $8,511.38
| Professional | | $6,760.83 | $8,511.38 | $8,511.38 |