- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,819.70 / $3,981.07 / $5,623.41
| Facility | | $1,819.70 | $3,981.07 | $5,623.41 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,862.09 / $2,238.72 / $3,715.35
| Professional | | $1,862.09 | $2,238.72 | $3,715.35 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,011.87 / $5,011.87 / $10,232.93
| Facility | | $5,011.87 | $5,011.87 | $10,232.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,454.71 / $2,454.71 / $7,943.28
| Professional | | $2,454.71 | $2,454.71 | $7,943.28 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,659.59 / $3,890.45 / $4,168.69
| Facility | | $1,659.59 | $3,890.45 | $4,168.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,659.59 / $3,890.45 / $4,168.69
| Professional | | $1,659.59 | $3,890.45 | $4,168.69 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,630.78 / $3,630.78 / $53,703.18
| Facility | | $3,630.78 | $3,630.78 | $53,703.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,090.30 / $3,090.30 / $5,248.07
| Professional | | $3,090.30 | $3,090.30 | $5,248.07 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,011.87 / $8,317.64 / $19,498.45
| Facility | | $5,011.87 | $8,317.64 | $19,498.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,311.31 / $5,370.32 / $9,549.93
| Professional | | $3,311.31 | $5,370.32 | $9,549.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,019.95 / $3,162.28 / $3,548.13
| Professional | | $3,019.95 | $3,162.28 | $3,548.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $50,118.72 / $53,703.18 / $75,857.76
| Facility | | $50,118.72 | $53,703.18 | $75,857.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,311.31 / $4,897.79 / $4,897.79
| Professional | | $3,311.31 | $4,897.79 | $4,897.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,071.52 / $2,691.53 / $5,495.41
| Facility | | $1,071.52 | $2,691.53 | $5,495.41 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,659.59 / $3,162.28 / $8,317.64
| Professional | | $1,659.59 | $3,162.28 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,630.27 / $3,019.95 / $3,019.95
| Facility | | $2,630.27 | $3,019.95 | $3,019.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,818.38 / $3,019.95 / $3,162.28
| Professional | | $2,818.38 | $3,019.95 | $3,162.28 |