- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,311.31 / $3,311.31 / $5,495.41
| Facility | | $3,311.31 | $3,311.31 | $5,495.41 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,884.03 / $3,467.37 / $5,495.41
| Professional | | $2,884.03 | $3,467.37 | $5,495.41 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,918.31 / $7,413.10 / $14,791.08
| Facility | | $6,918.31 | $7,413.10 | $14,791.08 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,388.44 / $4,265.80 / $9,120.11
| Professional | | $3,388.44 | $4,265.80 | $9,120.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,235.94 / $5,495.41 / $7,762.47
| Facility | | $3,235.94 | $5,495.41 | $7,762.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4,265.80 / $5,888.44 / $8,709.64
| Professional | | $4,265.80 | $5,888.44 | $8,709.64 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,466.84 / $4,466.84 / $4,677.35
| Facility | | $4,466.84 | $4,466.84 | $4,677.35 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,235.94 / $3,235.94 / $4,466.84
| Professional | | $3,235.94 | $3,235.94 | $4,466.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,466.84 / $4,466.84 / $4,466.84
| Facility | | $4,466.84 | $4,466.84 | $4,466.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,235.94 / $3,235.94 / $4,466.84
| Professional | | $3,235.94 | $3,235.94 | $4,466.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4,073.80 / $6,309.57 / $9,332.54
| Professional | | $4,073.80 | $6,309.57 | $9,332.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8,317.64 / $8,317.64 / $8,317.64
| Facility | | $8,317.64 | $8,317.64 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6,606.93 / $7,762.47 / $14,454.40
| Professional | | $6,606.93 | $7,762.47 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,951.21 / $5,623.41 / $8,912.51
| Facility | | $2,951.21 | $5,623.41 | $8,912.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,290.87 / $3,388.44 / $5,011.87
| Professional | | $2,290.87 | $3,388.44 | $5,011.87 |