- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,479.11 / $1,479.11 / $2,238.72
| Facility | | $1,479.11 | $1,479.11 | $2,238.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,584.89 / $2,344.23 / $2,818.38
| Professional | | $1,584.89 | $2,344.23 | $2,818.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,258.93 / $1,621.81 / $1,698.24
| Facility | | $1,258.93 | $1,621.81 | $1,698.24 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,584.89 / $1,621.81 / $1,698.24
| Professional | | $1,584.89 | $1,621.81 | $1,698.24 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,995.26 / $2,041.74 / $2,754.23
| Facility | | $1,995.26 | $2,041.74 | $2,754.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,513.56 / $1,905.46 / $2,398.83
| Professional | | $1,513.56 | $1,905.46 | $2,398.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,548.82 / $2,238.72 / $3,090.30
| Facility | | $1,548.82 | $2,238.72 | $3,090.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,479.11 / $1,548.82 / $2,818.38
| Professional | | $1,479.11 | $1,548.82 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,778.28 / $1,819.70 / $2,398.83
| Professional | | $1,778.28 | $1,819.70 | $2,398.83 |
- 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
- $1,819.70 / $2,398.83 / $3,890.45
| Professional | | $1,819.70 | $2,398.83 | $3,890.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,089.30 / $2,089.30 / $2,398.83
| Professional | | $2,089.30 | $2,089.30 | $2,398.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,479.11 / $1,479.11 / $3,981.07
| Facility | | $1,479.11 | $1,479.11 | $3,981.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,479.11 / $2,691.53 / $2,818.38
| Professional | | $1,479.11 | $2,691.53 | $2,818.38 |