- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,981.07 / $7,943.28 / $22,908.68
| Facility | | $3,981.07 | $7,943.28 | $22,908.68 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,949.84 / $2,691.53 / $5,248.07
| Professional | | $1,949.84 | $2,691.53 | $5,248.07 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $36,307.81 / $45,708.82 / $91,201.08
| Facility | | $36,307.81 | $45,708.82 | $91,201.08 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,951.21 / $4,168.69 / $5,888.44
| Professional | | $2,951.21 | $4,168.69 | $5,888.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $758.58 / $758.58 / $870.96
| Facility | | $758.58 | $758.58 | $870.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,137.96 / $3,467.37 / $6,309.57
| Professional | | $2,137.96 | $3,467.37 | $6,309.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,290.87 / $4,365.16 / $21,877.62
| Facility | | $2,290.87 | $4,365.16 | $21,877.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,290.87 / $4,265.80 / $16,595.87
| Professional | | $2,290.87 | $4,265.80 | $16,595.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $134.90
| Professional | | $32.36 | $33.11 | $134.90 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,691.53 / $4,168.69 / $4,265.80
| Facility | | $2,691.53 | $4,168.69 | $4,265.80 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,884.03 / $2,884.03 / $2,951.21
| Facility | | $2,884.03 | $2,884.03 | $2,951.21 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,951.21 / $4,265.80 / $5,623.41
| Professional | | $2,951.21 | $4,265.80 | $5,623.41 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $33,113.11 / $45,708.82 / $91,201.08
| Facility | | $33,113.11 | $45,708.82 | $91,201.08 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,951.21 / $4,168.69 / $5,754.40
| Professional | | $2,951.21 | $4,168.69 | $5,754.40 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,918.31 / $50,118.72 / $100,000.00
| Facility | | $6,918.31 | $50,118.72 | $100,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,238.72 / $3,162.28 / $5,623.41
| Professional | | $2,238.72 | $3,162.28 | $5,623.41 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,041.74 / $2,187.76 / $3,890.45
| Professional | | $2,041.74 | $2,187.76 | $3,890.45 |