- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,137.96 / $8,912.51 / $20,892.96
| Facility | | $2,137.96 | $8,912.51 | $20,892.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $912.01 / $1,288.25 / $2,818.38
| Professional | | $912.01 | $1,288.25 | $2,818.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14,125.38 / $18,197.01 / $35,481.34
| Facility | | $14,125.38 | $18,197.01 | $35,481.34 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,548.82 / $2,238.72 / $3,090.30
| Professional | | $1,548.82 | $2,238.72 | $3,090.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $707.95 / $758.58 / $870.96
| Facility | | $707.95 | $758.58 | $870.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,000.00 / $1,862.09 / $3,235.94
| Professional | | $1,000.00 | $1,862.09 | $3,235.94 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,071.52 / $2,290.87 / $8,709.64
| Facility | | $1,071.52 | $2,290.87 | $8,709.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,071.52 / $2,187.76 / $6,606.93
| Professional | | $1,071.52 | $2,187.76 | $6,606.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $75.86
| Professional | | $32.36 | $33.11 | $75.86 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,445.44 / $2,187.76 / $2,290.87
| Facility | | $1,445.44 | $2,187.76 | $2,290.87 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,513.56 / $1,513.56 / $1,584.89
| Facility | | $1,513.56 | $1,513.56 | $1,584.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,584.89 / $2,344.23 / $3,019.95
| Professional | | $1,584.89 | $2,344.23 | $3,019.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12,882.50 / $18,197.01 / $35,481.34
| Facility | | $12,882.50 | $18,197.01 | $35,481.34 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,548.82 / $2,238.72 / $3,090.30
| Professional | | $1,548.82 | $2,238.72 | $3,090.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,677.35 / $20,892.96 / $41,686.94
| Facility | | $4,677.35 | $20,892.96 | $41,686.94 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,174.90 / $1,513.56 / $2,951.21
| Professional | | $1,174.90 | $1,513.56 | $2,951.21 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,288.25 / $1,318.26 / $2,398.83
| Professional | | $1,288.25 | $1,318.26 | $2,398.83 |