- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,445.44 / $9,549.93 / $70,794.58
| Facility | | $1,445.44 | $9,549.93 | $70,794.58 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,011.87 / $8,128.31 / $13,489.63
| Facility | | $5,011.87 | $8,128.31 | $13,489.63 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,737.80 / $1,737.80 / $1,737.80
| Facility | | $1,737.80 | $1,737.80 | $1,737.80 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,801.89 / $4,365.16 / $7,079.46
| Facility | | $3,801.89 | $4,365.16 | $7,079.46 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,445.44 / $3,162.28 / $10,471.29
| Facility | | $1,445.44 | $3,162.28 | $10,471.29 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,445.44 / $3,162.28 / $21,379.62
| Facility | | $1,445.44 | $3,162.28 | $21,379.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,019.95 / $12,882.50 / $27,542.29
| Facility | | $3,019.95 | $12,882.50 | $27,542.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,238.72 / $3,388.44 / $5,011.87
| Professional | | $2,238.72 | $3,388.44 | $5,011.87 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,801.89 / $15,488.17 / $15,488.17
| Facility | | $3,801.89 | $15,488.17 | $15,488.17 |
- Facility/Professional
- Facility
- Modifier
- 62
- Typical Low / Median / Typical High
- $2,344.23 / $2,344.23 / $9,772.37
| Facility | 62 | $2,344.23 | $2,344.23 | $9,772.37 |
- Facility/Professional
- Facility
- Modifier
- AS
- Typical Low / Median / Typical High
- $380.19 / $380.19 / $1,548.82
| Facility | AS | $380.19 | $380.19 | $1,548.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4,786.30 / $4,786.30 / $4,786.30
| Professional | | $4,786.30 | $4,786.30 | $4,786.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9,549.93 / $18,197.01 / $28,840.32
| Facility | | $9,549.93 | $18,197.01 | $28,840.32 |