- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,918.31 / $6,918.31 / $10,232.93
| Facility | | $6,918.31 | $6,918.31 | $10,232.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5,495.41 / $6,760.83 / $10,964.78
| Professional | | $5,495.41 | $6,760.83 | $10,964.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14,454.40 / $15,135.61 / $30,902.95
| Facility | | $14,454.40 | $15,135.61 | $30,902.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7,079.46 / $8,511.38 / $18,620.87
| Professional | | $7,079.46 | $8,511.38 | $18,620.87 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,456.54 / $10,964.78 / $15,488.17
| Facility | | $6,456.54 | $10,964.78 | $15,488.17 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8,317.64 / $11,481.54 / $17,378.01
| Professional | | $8,317.64 | $11,481.54 | $17,378.01 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9,120.11 / $9,120.11 / $9,549.93
| Facility | | $9,120.11 | $9,120.11 | $9,549.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6,606.93 / $6,606.93 / $9,120.11
| Professional | | $6,606.93 | $6,606.93 | $9,120.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9,120.11 / $9,120.11 / $9,120.11
| Facility | | $9,120.11 | $9,120.11 | $9,120.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6,606.93 / $6,606.93 / $9,120.11
| Professional | | $6,606.93 | $6,606.93 | $9,120.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7,585.78 / $11,748.98 / $17,378.01
| Professional | | $7,585.78 | $11,748.98 | $17,378.01 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16,982.44 / $16,982.44 / $16,982.44
| Facility | | $16,982.44 | $16,982.44 | $16,982.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13,489.63 / $15,848.93 / $29,512.09
| Professional | | $13,489.63 | $15,848.93 | $29,512.09 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,495.41 / $10,232.93 / $14,454.40
| Facility | | $5,495.41 | $10,232.93 | $14,454.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4,677.35 / $6,918.31 / $9,332.54
| Professional | | $4,677.35 | $6,918.31 | $9,332.54 |