- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,621.81 / $4,365.16 / $5,495.41
| Facility | | $1,621.81 | $4,365.16 | $5,495.41 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $467.74 / $1,659.59 / $11,220.18
| Professional | | $467.74 | $1,659.59 | $11,220.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,570.88 / $10,000.00 / $18,620.87
| Facility | | $4,570.88 | $10,000.00 | $18,620.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $794.33 / $7,079.46 / $10,471.29
| Professional | | $794.33 | $7,079.46 | $10,471.29 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,168.69 / $4,168.69 / $4,265.80
| Facility | | $4,168.69 | $4,168.69 | $4,265.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $537.03 / $912.01 / $10,964.78
| Professional | | $537.03 | $912.01 | $10,964.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $467.74 / $4,786.30 / $13,803.84
| Facility | | $467.74 | $4,786.30 | $13,803.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $707.95 / $4,466.84 / $12,022.64
| Professional | | $707.95 | $4,466.84 | $12,022.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $32.36 / $33.11
| Professional | | $32.36 | $32.36 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12,882.50 / $16,218.10 / $22,908.68
| Facility | | $12,882.50 | $16,218.10 | $22,908.68 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $794.33 / $2,884.03 / $12,022.64
| Professional | | $794.33 | $2,884.03 | $12,022.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $724.44 / $5,370.32 / $13,489.63
| Professional | | $724.44 | $5,370.32 | $13,489.63 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,570.40 / $14,791.08 / $51,286.14
| Facility | | $2,570.40 | $14,791.08 | $51,286.14 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $549.54 / $1,380.38 / $12,589.25
| Professional | | $549.54 | $1,380.38 | $12,589.25 |