- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,248.07 / $5,248.07 / $28,840.32
| Facility | | $5,248.07 | $5,248.07 | $28,840.32 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4,365.16 / $5,248.07 / $8,709.64
| Professional | | $4,365.16 | $5,248.07 | $8,709.64 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10,471.29 / $10,471.29 / $17,378.01
| Facility | | $10,471.29 | $10,471.29 | $17,378.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9,772.37 / $9,772.37 / $11,748.98
| Professional | | $9,772.37 | $9,772.37 | $11,748.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,623.41 / $32,359.37 / $51,286.14
| Facility | | $5,623.41 | $32,359.37 | $51,286.14 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4,786.30 / $15,135.61 / $19,952.62
| Professional | | $4,786.30 | $15,135.61 | $19,952.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,248.07 / $8,511.38 / $12,302.69
| Facility | | $5,248.07 | $8,511.38 | $12,302.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10,232.93 / $11,481.54 / $12,589.25
| Professional | | $10,232.93 | $11,481.54 | $12,589.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,888.44 / $10,232.93 / $44,668.36
| Facility | | $5,888.44 | $10,232.93 | $44,668.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4,786.30 / $6,918.31 / $11,748.98
| Professional | | $4,786.30 | $6,918.31 | $11,748.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $50.12 / $64.57 / $70.79
| Professional | | $50.12 | $64.57 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9,120.11 / $12,882.50 / $25,703.96
| Professional | | $9,120.11 | $12,882.50 | $25,703.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10,471.29 / $15,848.93 / $28,840.32
| Professional | | $10,471.29 | $15,848.93 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,623.41 / $20,892.96 / $48,977.88
| Facility | | $5,623.41 | $20,892.96 | $48,977.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4,786.30 / $9,772.37 / $51,286.14
| Professional | | $4,786.30 | $9,772.37 | $51,286.14 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,370.32 / $6,918.31 / $7,413.10
| Facility | | $5,370.32 | $6,918.31 | $7,413.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,981.07 / $5,128.61 / $8,511.38
| Professional | | $3,981.07 | $5,128.61 | $8,511.38 |