- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,365.16 / $4,466.84 / $5,495.41
| Facility | | $4,365.16 | $4,466.84 | $5,495.41 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,023.29 / $1,412.54 / $2,290.87
| Professional | | $1,023.29 | $1,412.54 | $2,290.87 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,265.80 / $10,000.00 / $18,620.87
| Facility | | $4,265.80 | $10,000.00 | $18,620.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,819.70 / $2,137.96 / $2,238.72
| Professional | | $1,819.70 | $2,137.96 | $2,238.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,168.69 / $4,168.69 / $4,265.80
| Facility | | $4,168.69 | $4,168.69 | $4,265.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,023.29 / $1,479.11 / $1,949.84
| Professional | | $1,023.29 | $1,479.11 | $1,949.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,096.48 / $1,698.24 / $2,818.38
| Facility | | $1,096.48 | $1,698.24 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,698.24 / $1,905.46 / $2,570.40
| Professional | | $1,698.24 | $1,905.46 | $2,570.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $32.36 / $33.11
| Professional | | $32.36 | $32.36 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12,022.64 / $16,218.10 / $22,908.68
| Facility | | $12,022.64 | $16,218.10 | $22,908.68 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,621.81 / $2,238.72 / $2,691.53
| Professional | | $1,621.81 | $2,238.72 | $2,691.53 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $933.25 / $1,288.25 / $16,982.44
| Professional | | $933.25 | $1,288.25 | $16,982.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,089.30 / $14,791.08 / $27,542.29
| Facility | | $2,089.30 | $14,791.08 | $27,542.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,096.48 / $1,621.81 / $2,290.87
| Professional | | $1,096.48 | $1,621.81 | $2,290.87 |