- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,698.24 / $3,715.35 / $5,248.07
| Facility | | $1,698.24 | $3,715.35 | $5,248.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,949.84 / $2,398.83 / $3,981.07
| Professional | | $1,949.84 | $2,398.83 | $3,981.07 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,677.35 / $4,677.35 / $9,332.54
| Facility | | $4,677.35 | $4,677.35 | $9,332.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,818.38 / $2,818.38 / $7,943.28
| Professional | | $2,818.38 | $2,818.38 | $7,943.28 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,548.13 / $3,801.89 / $3,801.89
| Facility | | $3,548.13 | $3,801.89 | $3,801.89 |
- 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
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,548.13 / $3,548.13 / $53,703.18
| Facility | | $3,548.13 | $3,548.13 | $53,703.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,570.40 / $2,570.40 / $6,309.57
| Professional | | $2,570.40 | $2,570.40 | $6,309.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,677.35 / $7,762.47 / $17,782.79
| Facility | | $4,677.35 | $7,762.47 | $17,782.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,884.03 / $4,677.35 / $8,912.51
| Professional | | $2,884.03 | $4,677.35 | $8,912.51 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,398.83 / $2,398.83 / $2,511.89
| Facility | | $2,398.83 | $2,398.83 | $2,511.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,398.83 / $2,754.23 / $2,951.21
| Professional | | $2,398.83 | $2,754.23 | $2,951.21 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,248.07 / $50,118.72 / $75,857.76
| Facility | | $5,248.07 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,019.95 / $4,466.84 / $4,466.84
| Professional | | $3,019.95 | $4,466.84 | $4,466.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,905.46 / $3,467.37 / $13,182.57
| Facility | | $1,905.46 | $3,467.37 | $13,182.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,513.56 / $3,019.95 / $7,762.47
| Professional | | $1,513.56 | $3,019.95 | $7,762.47 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,398.83 / $2,754.23 / $2,884.03
| Facility | | $2,398.83 | $2,754.23 | $2,884.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,398.83 / $2,754.23 / $2,951.21
| Professional | | $2,398.83 | $2,754.23 | $2,951.21 |