- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,071.52 / $3,715.35 / $12,882.50
| Facility | | $1,071.52 | $3,715.35 | $12,882.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,000.00 / $1,174.90 / $1,905.46
| Professional | | $1,000.00 | $1,174.90 | $1,905.46 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,122.02 / $1,862.09 / $4,570.88
| Facility | | $1,122.02 | $1,862.09 | $4,570.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,000.00 / $1,230.27 / $1,778.28
| Professional | | $1,000.00 | $1,230.27 | $1,778.28 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $79.43 / $933.25 / $954.99
| Facility | | $79.43 | $933.25 | $954.99 |
- 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
- $1,047.13 / $1,445.44 / $2,398.83
| Professional | | $1,047.13 | $1,445.44 | $2,398.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $54.95 / $56.23 / $21,379.62
| Facility | | $54.95 | $56.23 | $21,379.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10,715.19 / $10,715.19 / $10,715.19
| Professional | | $10,715.19 | $10,715.19 | $10,715.19 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,000.00 / $1,584.89 / $4,677.35
| Facility | | $1,000.00 | $1,584.89 | $4,677.35 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,023.29 / $1,380.38 / $2,344.23
| Professional | | $1,023.29 | $1,380.38 | $2,344.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $141.25 / $933.25
| Professional | | $32.36 | $141.25 | $933.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,348.96 / $1,348.96 / $1,348.96
| Professional | | $1,348.96 | $1,348.96 | $1,348.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,000.00 / $1,445.44 / $2,511.89
| Facility | | $1,000.00 | $1,445.44 | $2,511.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,023.29 / $1,445.44 / $2,398.83
| Professional | | $1,023.29 | $1,445.44 | $2,398.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,238.72 / $6,165.95 / $11,481.54
| Facility | | $2,238.72 | $6,165.95 | $11,481.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $891.25 / $1,174.90 / $1,862.09
| Professional | | $891.25 | $1,174.90 | $1,862.09 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $912.01 / $933.25 / $977.24
| Professional | | $912.01 | $933.25 | $977.24 |