- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,621.81 / $4,073.80 / $10,964.78
| Facility | | $1,621.81 | $4,073.80 | $10,964.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $354.81 / $407.38 / $616.60
| Professional | | $354.81 | $407.38 | $616.60 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,630.27 / $4,786.30 / $10,000.00
| Facility | | $2,630.27 | $4,786.30 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $323.59 / $398.11 / $812.83
| Professional | | $323.59 | $398.11 | $812.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $37,153.52 / $37,153.52 / $37,153.52
| Facility | | $37,153.52 | $37,153.52 | $37,153.52 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $660.69 / $46,773.51 / $56,234.13
| Facility | | $660.69 | $46,773.51 | $56,234.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $380.19 / $616.60 / $1,905.46
| Professional | | $380.19 | $616.60 | $1,905.46 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $331.13 / $741.31 / $13,489.63
| Facility | | $331.13 | $741.31 | $13,489.63 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $831.76 / $1,202.26 / $1,621.81
| Professional | | $831.76 | $1,202.26 | $1,621.81 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $363.08 / $363.08 / $363.08
| Facility | | $363.08 | $363.08 | $363.08 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $316.23 / $524.81 / $812.83
| Professional | | $316.23 | $524.81 | $812.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $50,118.72 / $53,703.18 / $75,857.76
| Facility | | $50,118.72 | $53,703.18 | $75,857.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $398.11 / $398.11 / $537.03
| Professional | | $398.11 | $398.11 | $537.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,348.96 / $2,511.89 / $4,897.79
| Facility | | $1,348.96 | $2,511.89 | $4,897.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $323.59 / $588.84 / $2,570.40
| Professional | | $323.59 | $588.84 | $2,570.40 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $316.23 / $660.69 / $1,862.09
| Facility | | $316.23 | $660.69 | $1,862.09 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $316.23 / $549.54 / $1,230.27
| Professional | | $316.23 | $549.54 | $1,230.27 |