- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,041.74 / $4,265.80 / $14,454.40
| Facility | | $2,041.74 | $4,265.80 | $14,454.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,949.84 / $2,137.96 / $5,370.32
| Professional | | $1,949.84 | $2,137.96 | $5,370.32 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11,748.98 / $15,488.17 / $26,302.68
| Facility | | $11,748.98 | $15,488.17 | $26,302.68 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,089.30 / $4,265.80 / $11,748.98
| Professional | | $2,089.30 | $4,265.80 | $11,748.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,370.32 / $6,309.57 / $10,000.00
| Facility | | $5,370.32 | $6,309.57 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,570.40 / $8,317.64 / $10,000.00
| Professional | | $2,570.40 | $8,317.64 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,089.30 / $4,365.16 / $10,471.29
| Facility | | $2,089.30 | $4,365.16 | $10,471.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,715.35 / $5,011.87 / $6,456.54
| Professional | | $3,715.35 | $5,011.87 | $6,456.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,089.30 / $4,466.84 / $19,498.45
| Facility | | $2,089.30 | $4,466.84 | $19,498.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,290.87 / $3,981.07 / $31,622.78
| Professional | | $2,290.87 | $3,981.07 | $31,622.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $70.79
| Professional | | $32.36 | $33.11 | $70.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,365.16 / $12,882.50 / $27,542.29
| Facility | | $4,365.16 | $12,882.50 | $27,542.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,570.40 / $5,128.61 / $8,912.51
| Professional | | $2,570.40 | $5,128.61 | $8,912.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,019.95 / $4,570.88 / $6,760.83
| Professional | | $3,019.95 | $4,570.88 | $6,760.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,370.32 / $26,915.35 / $26,915.35
| Facility | | $5,370.32 | $26,915.35 | $26,915.35 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,715.35 / $10,232.93 / $31,622.78
| Professional | | $3,715.35 | $10,232.93 | $31,622.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6,760.83 / $6,760.83 / $6,760.83
| Professional | | $6,760.83 | $6,760.83 | $6,760.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6,025.60 / $12,882.50 / $13,182.57
| Professional | | $6,025.60 | $12,882.50 | $13,182.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9,549.93 / $17,378.01 / $23,442.29
| Facility | | $9,549.93 | $17,378.01 | $23,442.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,187.76 / $3,235.94 / $8,709.64
| Professional | | $2,187.76 | $3,235.94 | $8,709.64 |