- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7,244.36 / $7,585.78 / $8,511.38
| Facility | | $7,244.36 | $7,585.78 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4,168.69 / $5,370.32 / $8,317.64
| Professional | | $4,168.69 | $5,370.32 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7,943.28 / $7,943.28 / $10,964.78
| Facility | | $7,943.28 | $7,943.28 | $10,964.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7,943.28 / $11,748.98 / $14,791.08
| Professional | | $7,943.28 | $11,748.98 | $14,791.08 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9,332.54 / $10,715.19 / $12,882.50
| Professional | | $9,332.54 | $10,715.19 | $12,882.50 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7,585.78 / $12,882.50 / $42,657.95
| Facility | | $7,585.78 | $12,882.50 | $42,657.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4,570.88 / $6,760.83 / $16,218.10
| Professional | | $4,570.88 | $6,760.83 | $16,218.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10,715.19 / $11,220.18 / $13,489.63
| Professional | | $10,715.19 | $11,220.18 | $13,489.63 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10,964.78 / $10,964.78 / $10,964.78
| Facility | | $10,964.78 | $10,964.78 | $10,964.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10,232.93 / $16,218.10 / $16,218.10
| Professional | | $10,232.93 | $16,218.10 | $16,218.10 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,466.84 / $10,000.00 / $23,988.33
| Facility | | $4,466.84 | $10,000.00 | $23,988.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4,570.88 / $5,248.07 / $9,332.54
| Professional | | $4,570.88 | $5,248.07 | $9,332.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7,762.47 / $9,772.37 / $9,772.37
| Professional | | $7,762.47 | $9,772.37 | $9,772.37 |