- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,630.27 / $13,803.84 / $41,686.94
| Facility | | $2,630.27 | $13,803.84 | $41,686.94 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,288.25 / $1,862.09 / $5,754.40
| Professional | | $1,288.25 | $1,862.09 | $5,754.40 |
- Facility/Professional
- Professional
- Modifier
- AS
- Typical Low / Median / Typical High
- $194.98 / $371.54 / $794.33
| Professional | AS | $194.98 | $371.54 | $794.33 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $851.14 / $851.14 / $851.14
| Facility | | $851.14 | $851.14 | $851.14 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,737.80 / $2,754.23 / $3,801.89
| Professional | | $1,737.80 | $2,754.23 | $3,801.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,398.83 / $2,818.38 / $3,548.13
| Professional | | $2,398.83 | $2,818.38 | $3,548.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,621.81 / $2,630.27 / $19,952.62
| Facility | | $1,621.81 | $2,630.27 | $19,952.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,949.84 / $2,630.27 / $3,801.89
| Professional | | $1,949.84 | $2,630.27 | $3,801.89 |
- Facility/Professional
- Professional
- Modifier
- AS
- Typical Low / Median / Typical High
- $186.21 / $371.54 / $549.54
| Professional | AS | $186.21 | $371.54 | $549.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,041.74 / $2,818.38 / $2,884.03
| Facility | | $2,041.74 | $2,818.38 | $2,884.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,479.11 / $2,398.83 / $3,467.37
| Facility | | $1,479.11 | $2,398.83 | $3,467.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $79.43 / $2,754.23 / $3,890.45
| Professional | | $79.43 | $2,754.23 | $3,890.45 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15,848.93 / $44,668.36 / $69,183.10
| Facility | | $15,848.93 | $44,668.36 | $69,183.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,630.27 / $3,311.31 / $4,365.16
| Professional | | $2,630.27 | $3,311.31 | $4,365.16 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11,748.98 / $31,622.78 / $75,857.76
| Facility | | $11,748.98 | $31,622.78 | $75,857.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,949.84 / $2,754.23 / $3,890.45
| Professional | | $1,949.84 | $2,754.23 | $3,890.45 |
- Facility/Professional
- Professional
- Modifier
- AS
- Typical Low / Median / Typical High
- $524.81 / $524.81 / $524.81
| Professional | AS | $524.81 | $524.81 | $524.81 |