- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,311.31 / $8,128.31 / $20,892.96
| Facility | | $3,311.31 | $8,128.31 | $20,892.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,412.54 / $1,949.84 / $4,466.84
| Professional | | $1,412.54 | $1,949.84 | $4,466.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,760.83 / $9,549.93 / $19,498.45
| Facility | | $6,760.83 | $9,549.93 | $19,498.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,041.74 / $3,311.31 / $4,897.79
| Professional | | $2,041.74 | $3,311.31 | $4,897.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $794.33 / $1,288.25 / $4,677.35
| Facility | | $794.33 | $1,288.25 | $4,677.35 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,041.74 / $3,019.95 / $5,370.32
| Professional | | $2,041.74 | $3,019.95 | $5,370.32 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,290.87 / $3,715.35 / $9,549.93
| Facility | | $2,290.87 | $3,715.35 | $9,549.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,290.87 / $3,548.13 / $4,897.79
| Professional | | $2,290.87 | $3,548.13 | $4,897.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $114.82
| Professional | | $32.36 | $33.11 | $114.82 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,187.76 / $3,311.31 / $3,548.13
| Facility | | $2,187.76 | $3,311.31 | $3,548.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,995.26 / $2,398.83 / $2,454.71
| Facility | | $1,995.26 | $2,398.83 | $2,454.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,454.71 / $3,548.13 / $5,128.61
| Professional | | $2,454.71 | $3,548.13 | $5,128.61 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,760.83 / $10,000.00 / $19,498.45
| Facility | | $6,760.83 | $10,000.00 | $19,498.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,041.74 / $3,311.31 / $4,570.88
| Professional | | $2,041.74 | $3,311.31 | $4,570.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,951.21 / $11,220.18 / $20,417.38
| Facility | | $2,951.21 | $11,220.18 | $20,417.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,905.46 / $2,398.83 / $4,677.35
| Professional | | $1,905.46 | $2,398.83 | $4,677.35 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,737.80 / $2,137.96 / $3,311.31
| Professional | | $1,737.80 | $2,137.96 | $3,311.31 |