- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $977.24 / $5,754.40 / $11,481.54
| Facility | | $977.24 | $5,754.40 | $11,481.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $371.54 / $794.33 / $2,344.23
| Professional | | $371.54 | $794.33 | $2,344.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $338.84 / $724.44 / $1,023.29
| Professional | | $338.84 | $724.44 | $1,023.29 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,248.07 / $6,606.93 / $13,489.63
| Facility | | $5,248.07 | $6,606.93 | $13,489.63 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $467.74 / $758.58 / $1,148.15
| Professional | | $467.74 | $758.58 | $1,148.15 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,862.09 / $1,862.09 / $1,862.09
| Facility | | $1,862.09 | $1,862.09 | $1,862.09 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $660.69 / $1,202.26 / $1,737.80
| Professional | | $660.69 | $1,202.26 | $1,737.80 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $501.19 / $1,000.00 / $6,025.60
| Facility | | $501.19 | $1,000.00 | $6,025.60 |
- Facility/Professional
- Facility
- Modifier
- AS
- Typical Low / Median / Typical High
- $194.98 / $194.98 / $194.98
| Facility | AS | $194.98 | $194.98 | $194.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $537.03 / $977.24 / $3,090.30
| Professional | | $537.03 | $977.24 | $3,090.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $933.25 / $1,288.25 / $1,778.28
| Professional | | $933.25 | $1,288.25 | $1,778.28 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,862.09 / $1,862.09 / $1,862.09
| Facility | | $1,862.09 | $1,862.09 | $1,862.09 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $812.83 / $1,288.25 / $1,862.09
| Professional | | $812.83 | $1,288.25 | $1,862.09 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9,120.11 / $9,120.11 / $10,715.19
| Facility | | $9,120.11 | $9,120.11 | $10,715.19 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,630.78 / $4,365.16 / $6,760.83
| Facility | | $3,630.78 | $4,365.16 | $6,760.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $501.19 / $851.14 / $1,412.54
| Professional | | $501.19 | $851.14 | $1,412.54 |