- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,698.24 / $6,165.95 / $22,908.68
| Facility | | $1,698.24 | $6,165.95 | $22,908.68 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $758.58 / $1,659.59 / $3,801.89
| Professional | | $758.58 | $1,659.59 | $3,801.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10,715.19 / $15,488.17 / $31,622.78
| Facility | | $10,715.19 | $15,488.17 | $31,622.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,148.15 / $2,137.96 / $4,466.84
| Professional | | $1,148.15 | $2,137.96 | $4,466.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,380.38 / $1,479.11 / $9,332.54
| Facility | | $1,380.38 | $1,479.11 | $9,332.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $870.96 / $2,137.96 / $4,786.30
| Professional | | $870.96 | $2,137.96 | $4,786.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,047.13 / $2,691.53 / $5,754.40
| Facility | | $1,047.13 | $2,691.53 | $5,754.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,047.13 / $2,344.23 / $5,370.32
| Professional | | $1,047.13 | $2,344.23 | $5,370.32 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $407.38
| Professional | | $32.36 | $33.11 | $407.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,137.96 / $3,467.37 / $4,365.16
| Facility | | $2,137.96 | $3,467.37 | $4,365.16 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,398.83 / $2,398.83 / $2,398.83
| Facility | | $2,398.83 | $2,398.83 | $2,398.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,047.13 / $2,398.83 / $4,365.16
| Professional | | $1,047.13 | $2,398.83 | $4,365.16 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10,715.19 / $16,218.10 / $31,622.78
| Facility | | $10,715.19 | $16,218.10 | $31,622.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,096.48 / $2,137.96 / $4,466.84
| Professional | | $1,096.48 | $2,137.96 | $4,466.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,467.37 / $17,378.01 / $33,884.42
| Facility | | $3,467.37 | $17,378.01 | $33,884.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,000.00 / $2,089.30 / $4,365.16
| Professional | | $1,000.00 | $2,089.30 | $4,365.16 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $758.58 / $1,445.44 / $2,630.27
| Professional | | $758.58 | $1,445.44 | $2,630.27 |