- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,819.70 / $8,128.31 / $25,703.96
| Facility | | $1,819.70 | $8,128.31 | $25,703.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,318.26 / $1,862.09 / $4,897.79
| Professional | | $1,318.26 | $1,862.09 | $4,897.79 |
- Facility/Professional
- Professional
- Modifier
- AS
- Typical Low / Median / Typical High
- $194.98 / $346.74 / $3,162.28
| Professional | AS | $194.98 | $346.74 | $3,162.28 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $26,915.35 / $30,199.52 / $30,199.52
| Facility | | $26,915.35 | $30,199.52 | $30,199.52 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,380.38 / $2,089.30 / $3,548.13
| Professional | | $1,380.38 | $2,089.30 | $3,548.13 |
- Facility/Professional
- Professional
- Modifier
- AS
- Typical Low / Median / Typical High
- $194.98 / $288.40 / $501.19
| Professional | AS | $194.98 | $288.40 | $501.19 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $891.25 / $1,584.89 / $3,235.94
| Professional | | $891.25 | $1,584.89 | $3,235.94 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $645.65 / $645.65 / $645.65
| Facility | | $645.65 | $645.65 | $645.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,380.38 / $1,862.09 / $3,090.30
| Professional | | $1,380.38 | $1,862.09 | $3,090.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,258.93 / $1,584.89 / $1,862.09
| Professional | | $1,258.93 | $1,584.89 | $1,862.09 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,041.74 / $2,511.89 / $3,311.31
| Professional | | $2,041.74 | $2,511.89 | $3,311.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,380.38 / $1,905.46 / $2,951.21
| Facility | | $1,380.38 | $1,905.46 | $2,951.21 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,819.70 / $1,819.70 / $1,819.70
| Professional | | $1,819.70 | $1,819.70 | $1,819.70 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,348.96 / $1,905.46 / $15,135.61
| Facility | | $1,348.96 | $1,905.46 | $15,135.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,348.96 / $1,905.46 / $15,135.61
| Professional | | $1,348.96 | $1,905.46 | $15,135.61 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10,715.19 / $23,988.33 / $41,686.94
| Facility | | $10,715.19 | $23,988.33 | $41,686.94 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,122.02 / $1,737.80 / $2,951.21
| Professional | | $1,122.02 | $1,737.80 | $2,951.21 |