- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,677.35 / $8,128.31 / $20,892.96
| Facility | | $4,677.35 | $8,128.31 | $20,892.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,238.72 / $3,090.30 / $6,760.83
| Professional | | $2,238.72 | $3,090.30 | $6,760.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,801.89 / $4,897.79 / $10,000.00
| Facility | | $3,801.89 | $4,897.79 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,162.28 / $4,897.79 / $7,413.10
| Professional | | $3,162.28 | $4,897.79 | $7,413.10 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $794.33 / $1,288.25 / $2,344.23
| Facility | | $794.33 | $1,288.25 | $2,344.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,162.28 / $4,570.88 / $8,128.31
| Professional | | $3,162.28 | $4,570.88 | $8,128.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,398.83 / $5,128.61 / $7,413.10
| Facility | | $2,398.83 | $5,128.61 | $7,413.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,398.83 / $4,897.79 / $6,918.31
| Professional | | $2,398.83 | $4,897.79 | $6,918.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $173.78
| Professional | | $32.36 | $33.11 | $173.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,630.27 / $5,248.07 / $5,370.32
| Facility | | $2,630.27 | $5,248.07 | $5,370.32 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,071.52 / $3,630.78 / $3,715.35
| Facility | | $1,071.52 | $3,630.78 | $3,715.35 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,715.35 / $5,370.32 / $7,762.47
| Professional | | $3,715.35 | $5,370.32 | $7,762.47 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,548.13 / $5,011.87 / $10,000.00
| Facility | | $3,548.13 | $5,011.87 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,162.28 / $4,897.79 / $6,760.83
| Professional | | $3,162.28 | $4,897.79 | $6,760.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,698.24 / $6,456.54 / $11,748.98
| Facility | | $1,698.24 | $6,456.54 | $11,748.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,951.21 / $3,630.78 / $7,079.46
| Professional | | $2,951.21 | $3,630.78 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,570.40 / $3,162.28 / $4,897.79
| Professional | | $2,570.40 | $3,162.28 | $4,897.79 |