- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,187.76 / $8,912.51 / $25,703.96
| Facility | | $2,187.76 | $8,912.51 | $25,703.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,318.26 / $1,995.26 / $3,890.45
| Professional | | $1,318.26 | $1,995.26 | $3,890.45 |
- Facility/Professional
- Professional
- Modifier
- AS
- Typical Low / Median / Typical High
- $186.21 / $323.59 / $831.76
| Professional | AS | $186.21 | $323.59 | $831.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $169.82 / $1,258.93 / $1,949.84
| Professional | | $169.82 | $1,258.93 | $1,949.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,235.94 / $8,317.64 / $30,199.52
| Facility | | $3,235.94 | $8,317.64 | $30,199.52 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,348.96 / $1,737.80 / $2,691.53
| Professional | | $1,348.96 | $1,737.80 | $2,691.53 |
- Facility/Professional
- Professional
- Modifier
- AS
- Typical Low / Median / Typical High
- $186.21 / $245.47 / $371.54
| Professional | AS | $186.21 | $245.47 | $371.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,479.11 / $1,513.56 / $1,778.28
| Professional | | $1,479.11 | $1,513.56 | $1,778.28 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,412.54 / $1,778.28 / $2,344.23
| Facility | | $1,412.54 | $1,778.28 | $2,344.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,412.54 / $1,819.70 / $3,311.31
| Professional | | $1,412.54 | $1,819.70 | $3,311.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,737.80 / $2,290.87 / $21,379.62
| Facility | | $1,737.80 | $2,290.87 | $21,379.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,288.25 / $1,995.26 / $2,884.03
| Professional | | $1,288.25 | $1,995.26 | $2,884.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,073.80 / $7,585.78 / $26,302.68
| Facility | | $4,073.80 | $7,585.78 | $26,302.68 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,230.27 / $1,905.46 / $2,818.38
| Professional | | $1,230.27 | $1,905.46 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $263.03
| Professional | | $32.36 | $33.11 | $263.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $100.00 / $100.00 / $21,379.62
| Facility | | $100.00 | $100.00 | $21,379.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,318.26 / $1,659.59 / $2,818.38
| Professional | | $1,318.26 | $1,659.59 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- AS
- Typical Low / Median / Typical High
- $371.54 / $371.54 / $371.54
| Professional | AS | $371.54 | $371.54 | $371.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,918.31 / $13,803.84 / $35,481.34
| Facility | | $6,918.31 | $13,803.84 | $35,481.34 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,096.48 / $1,659.59 / $2,630.27
| Professional | | $1,096.48 | $1,659.59 | $2,630.27 |
- Facility/Professional
- Professional
- Modifier
- AS
- Typical Low / Median / Typical High
- $457.09 / $457.09 / $457.09
| Professional | AS | $457.09 | $457.09 | $457.09 |