- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,096.48 / $1,737.80 / $8,709.64
| Facility | | $1,096.48 | $1,737.80 | $8,709.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,000.00 / $1,174.90 / $2,187.76
| Professional | | $1,000.00 | $1,174.90 | $2,187.76 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12,882.50 / $12,882.50 / $13,182.57
| Facility | | $12,882.50 | $12,882.50 | $13,182.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,174.90 / $1,479.11 / $3,235.94
| Professional | | $1,174.90 | $1,479.11 | $3,235.94 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $602.56 / $602.56 / $602.56
| Facility | | $602.56 | $602.56 | $602.56 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,148.15 / $1,513.56 / $2,454.71
| Professional | | $1,148.15 | $1,513.56 | $2,454.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,737.80 / $1,737.80 / $2,570.40
| Professional | | $1,737.80 | $1,737.80 | $2,570.40 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,096.48 / $1,445.44 / $2,238.72
| Facility | | $1,096.48 | $1,445.44 | $2,238.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,548.82 / $1,949.84 / $2,398.83
| Professional | | $1,548.82 | $1,949.84 | $2,398.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,456.54 / $14,791.08 / $23,442.29
| Facility | | $6,456.54 | $14,791.08 | $23,442.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $933.25 / $1,230.27 / $2,344.23
| Professional | | $933.25 | $1,230.27 | $2,344.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $56.23 / $38,018.94 / $38,018.94
| Facility | | $56.23 | $38,018.94 | $38,018.94 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8,128.31 / $8,128.31 / $9,772.37
| Professional | | $8,128.31 | $8,128.31 | $9,772.37 |