- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,570.88 / $7,943.28 / $22,908.68
| Facility | | $4,570.88 | $7,943.28 | $22,908.68 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,238.72 / $3,019.95 / $6,025.60
| Professional | | $2,238.72 | $3,019.95 | $6,025.60 |
- 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
- $3,388.44 / $4,786.30 / $6,760.83
| Professional | | $3,388.44 | $4,786.30 | $6,760.83 |
- 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
- $2,454.71 / $4,168.69 / $7,413.10
| Professional | | $2,454.71 | $4,168.69 | $7,413.10 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,630.27 / $5,011.87 / $21,877.62
| Facility | | $2,630.27 | $5,011.87 | $21,877.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,630.27 / $4,897.79 / $16,595.87
| Professional | | $2,630.27 | $4,897.79 | $16,595.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $158.49
| Professional | | $32.36 | $33.11 | $158.49 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,884.03 / $4,786.30 / $5,011.87
| Facility | | $2,884.03 | $4,786.30 | $5,011.87 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,311.31 / $3,311.31 / $3,388.44
| Facility | | $3,311.31 | $3,311.31 | $3,388.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,388.44 / $5,011.87 / $6,456.54
| Professional | | $3,388.44 | $5,011.87 | $6,456.54 |
- 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
- $3,388.44 / $4,786.30 / $6,606.93
| Professional | | $3,388.44 | $4,786.30 | $6,606.93 |
- 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
- $2,691.53 / $3,801.89 / $6,456.54
| Professional | | $2,691.53 | $3,801.89 | $6,456.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,344.23 / $2,511.89 / $4,466.84
| Professional | | $2,344.23 | $2,511.89 | $4,466.84 |