- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,819.70 / $7,244.36 / $18,620.87
| Facility | | $1,819.70 | $7,244.36 | $18,620.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,288.25 / $1,819.70 / $3,801.89
| Professional | | $1,288.25 | $1,819.70 | $3,801.89 |
- Facility/Professional
- Professional
- Modifier
- AS
- Typical Low / Median / Typical High
- $186.21 / $380.19 / $3,162.28
| Professional | AS | $186.21 | $380.19 | $3,162.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $234.42 / $1,698.24 / $2,454.71
| Professional | | $234.42 | $1,698.24 | $2,454.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,235.94 / $9,332.54 / $15,135.61
| Facility | | $3,235.94 | $9,332.54 | $15,135.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,584.89 / $2,454.71 / $26,915.35
| Professional | | $1,584.89 | $2,454.71 | $26,915.35 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $30.20 / $30.20 / $30.20
| Facility | | $30.20 | $30.20 | $30.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,348.96 / $1,995.26 / $3,019.95
| Professional | | $1,348.96 | $1,995.26 | $3,019.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $54.95 / $77,624.71 / $77,624.71
| Facility | | $54.95 | $77,624.71 | $77,624.71 |
- 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
- $10,471.29 / $12,302.69 / $12,302.69
| Professional | | $10,471.29 | $12,302.69 | $12,302.69 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,456.54 / $12,589.25 / $26,915.35
| Facility | | $6,456.54 | $12,589.25 | $26,915.35 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,288.25 / $1,737.80 / $2,951.21
| Professional | | $1,288.25 | $1,737.80 | $2,951.21 |