- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,951.21 / $3,019.95 / $8,128.31
| Facility | | $2,951.21 | $3,019.95 | $8,128.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,454.71 / $2,951.21 / $4,466.84
| Professional | | $2,454.71 | $2,951.21 | $4,466.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,090.30 / $3,090.30 / $6,456.54
| Professional | | $3,090.30 | $3,090.30 | $6,456.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,388.44 / $3,388.44 / $3,890.45
| Professional | | $3,388.44 | $3,388.44 | $3,890.45 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,137.96 / $4,570.88 / $4,570.88
| Facility | | $2,137.96 | $4,570.88 | $4,570.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,890.45 / $3,890.45 / $3,890.45
| Professional | | $3,890.45 | $3,890.45 | $3,890.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4,265.80 / $5,754.40 / $7,943.28
| Professional | | $4,265.80 | $5,754.40 | $7,943.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,884.03 / $3,801.89 / $3,801.89
| Professional | | $2,884.03 | $3,801.89 | $3,801.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,398.83 / $4,073.80 / $6,918.31
| Facility | | $2,398.83 | $4,073.80 | $6,918.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,090.30 / $3,467.37 / $3,715.35
| Professional | | $3,090.30 | $3,467.37 | $3,715.35 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,235.94 / $4,677.35 / $8,317.64
| Facility | | $3,235.94 | $4,677.35 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,235.94 / $4,677.35 / $8,317.64
| Professional | | $3,235.94 | $4,677.35 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,995.26 / $3,801.89 / $3,981.07
| Facility | | $1,995.26 | $3,801.89 | $3,981.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,630.27 / $2,818.38 / $4,466.84
| Professional | | $2,630.27 | $2,818.38 | $4,466.84 |