- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,995.26 / $1,995.26 / $1,995.26
| Facility | | $1,995.26 | $1,995.26 | $1,995.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,348.96 / $1,949.84 / $2,691.53
| Professional | | $1,348.96 | $1,949.84 | $2,691.53 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,981.07 / $3,981.07 / $6,606.93
| Facility | | $3,981.07 | $3,981.07 | $6,606.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,388.44 / $3,715.35 / $4,365.16
| Professional | | $3,388.44 | $3,715.35 | $4,365.16 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,238.72 / $9,332.54 / $19,498.45
| Facility | | $2,238.72 | $9,332.54 | $19,498.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,905.46 / $5,754.40 / $7,585.78
| Professional | | $1,905.46 | $5,754.40 | $7,585.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,949.84 / $3,235.94 / $5,011.87
| Facility | | $1,949.84 | $3,235.94 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,238.72 / $3,548.13 / $4,786.30
| Professional | | $2,238.72 | $3,548.13 | $4,786.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,995.26 / $3,890.45 / $15,488.17
| Facility | | $1,995.26 | $3,890.45 | $15,488.17 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,479.11 / $2,238.72 / $4,466.84
| Professional | | $1,479.11 | $2,238.72 | $4,466.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $54.95 / $70.79 / $3,981.07
| Professional | | $54.95 | $70.79 | $3,981.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,818.38 / $4,570.88 / $7,943.28
| Professional | | $2,818.38 | $4,570.88 | $7,943.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,981.07 / $6,025.60 / $9,332.54
| Professional | | $3,981.07 | $6,025.60 | $9,332.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,238.72 / $7,943.28 / $15,488.17
| Facility | | $2,238.72 | $7,943.28 | $15,488.17 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,905.46 / $3,801.89 / $17,782.79
| Professional | | $1,905.46 | $3,801.89 | $17,782.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $776.25 / $1,949.84 / $2,398.83
| Facility | | $776.25 | $1,949.84 | $2,398.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,318.26 / $1,949.84 / $3,235.94
| Professional | | $1,318.26 | $1,949.84 | $3,235.94 |