- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,238.72 / $5,248.07 / $26,302.68
| Facility | | $2,238.72 | $5,248.07 | $26,302.68 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,258.93 / $1,995.26 / $5,370.32
| Professional | | $1,258.93 | $1,995.26 | $5,370.32 |
- Facility/Professional
- Professional
- Modifier
- AS
- Typical Low / Median / Typical High
- $177.83 / $478.63 / $1,174.90
| Professional | AS | $177.83 | $478.63 | $1,174.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,905.46 / $3,311.31 / $4,073.80
| Professional | | $1,905.46 | $3,311.31 | $4,073.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,348.96 / $2,041.74 / $6,309.57
| Professional | | $1,348.96 | $2,041.74 | $6,309.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,238.72 / $3,801.89 / $45,708.82
| Facility | | $2,238.72 | $3,801.89 | $45,708.82 |
- Facility/Professional
- Facility
- Modifier
- AS
- Typical Low / Median / Typical High
- $7,762.47 / $7,762.47 / $7,762.47
| Facility | AS | $7,762.47 | $7,762.47 | $7,762.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,445.44 / $2,884.03 / $10,715.19
| Professional | | $1,445.44 | $2,884.03 | $10,715.19 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,090.30 / $3,388.44 / $3,890.45
| Professional | | $3,090.30 | $3,388.44 | $3,890.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,818.38 / $2,884.03 / $3,890.45
| Professional | | $2,818.38 | $2,884.03 | $3,890.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,348.96 / $2,398.83 / $3,162.28
| Professional | | $1,348.96 | $2,398.83 | $3,162.28 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9,549.93 / $17,782.79 / $46,773.51
| Facility | | $9,549.93 | $17,782.79 | $46,773.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,380.38 / $2,137.96 / $4,365.16
| Professional | | $1,380.38 | $2,137.96 | $4,365.16 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,238.72 / $2,818.38 / $3,311.31
| Professional | | $2,238.72 | $2,818.38 | $3,311.31 |