- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,949.84 / $1,949.84 / $19,054.61
| Facility | | $1,949.84 | $1,949.84 | $19,054.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,412.54 / $1,949.84 / $16,595.87
| Professional | | $1,412.54 | $1,949.84 | $16,595.87 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,479.11 / $1,905.46 / $8,709.64
| Facility | | $1,479.11 | $1,905.46 | $8,709.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,995.26 / $1,995.26 / $5,370.32
| Professional | | $1,995.26 | $1,995.26 | $5,370.32 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,630.27 / $6,456.54 / $10,232.93
| Facility | | $2,630.27 | $6,456.54 | $10,232.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4,168.69 / $8,128.31 / $16,595.87
| Professional | | $4,168.69 | $8,128.31 | $16,595.87 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,041.74 / $2,691.53 / $2,691.53
| Facility | | $2,041.74 | $2,691.53 | $2,691.53 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,949.84 / $1,949.84 / $2,691.53
| Professional | | $1,949.84 | $1,949.84 | $2,691.53 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,148.15 / $1,412.54 / $5,370.32
| Professional | | $1,148.15 | $1,412.54 | $5,370.32 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,691.53 / $3,981.07 / $6,918.31
| Professional | | $2,691.53 | $3,981.07 | $6,918.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $17,782.79 / $17,782.79 / $17,782.79
| Facility | | $17,782.79 | $17,782.79 | $17,782.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $21,379.62 / $24,547.09 / $24,547.09
| Professional | | $21,379.62 | $24,547.09 | $24,547.09 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,801.89 / $3,801.89 / $3,801.89
| Professional | | $3,801.89 | $3,801.89 | $3,801.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $54.95 / $54.95 / $70.79
| Professional | | $54.95 | $54.95 | $70.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,202.26 / $3,801.89 / $5,370.32
| Facility | | $1,202.26 | $3,801.89 | $5,370.32 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,949.84 / $1,949.84 / $4,168.69
| Professional | | $1,949.84 | $1,949.84 | $4,168.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8,317.64 / $8,317.64 / $8,317.64
| Professional | | $8,317.64 | $8,317.64 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,148.15 / $1,479.11 / $3,981.07
| Professional | | $1,148.15 | $1,479.11 | $3,981.07 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $269.15 / $2,187.76 / $4,466.84
| Facility | | $269.15 | $2,187.76 | $4,466.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,548.82 / $1,949.84 / $4,570.88
| Professional | | $1,548.82 | $1,949.84 | $4,570.88 |