- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,691.53 / $4,466.84 / $14,454.40
| Facility | | $2,691.53 | $4,466.84 | $14,454.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $457.09 / $1,380.38 / $10,000.00
| Professional | | $457.09 | $1,380.38 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $56.23 / $4,677.35 / $19,054.61
| Facility | | $56.23 | $4,677.35 | $19,054.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $512.86 / $4,570.88 / $17,378.01
| Professional | | $512.86 | $4,570.88 | $17,378.01 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $549.54 / $549.54 / $1,288.25
| Facility | | $549.54 | $549.54 | $1,288.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,235.94 / $3,235.94 / $39,810.72
| Professional | | $3,235.94 | $3,235.94 | $39,810.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $549.54 / $1,659.59 / $15,135.61
| Professional | | $549.54 | $1,659.59 | $15,135.61 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $426.58 / $602.56 / $3,630.78
| Facility | | $426.58 | $602.56 | $3,630.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6,760.83 / $8,317.64 / $11,748.98
| Professional | | $6,760.83 | $8,317.64 | $11,748.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,090.30 / $6,918.31 / $19,498.45
| Facility | | $3,090.30 | $6,918.31 | $19,498.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $512.86 / $5,888.44 / $14,791.08
| Professional | | $512.86 | $5,888.44 | $14,791.08 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,445.44 / $3,467.37 / $3,630.78
| Facility | | $1,445.44 | $3,467.37 | $3,630.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $56.23 / $4,677.35 / $19,054.61
| Facility | | $56.23 | $4,677.35 | $19,054.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $512.86 / $4,570.88 / $17,378.01
| Professional | | $512.86 | $4,570.88 | $17,378.01 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,884.03 / $7,244.36 / $19,498.45
| Facility | | $2,884.03 | $7,244.36 | $19,498.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $537.03 / $5,248.07 / $15,488.17
| Professional | | $537.03 | $5,248.07 | $15,488.17 |