- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,897.79 / $10,471.29 / $19,952.62
| Facility | | $4,897.79 | $10,471.29 | $19,952.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,000.00 / $1,548.82 / $6,025.60
| Professional | | $1,000.00 | $1,548.82 | $6,025.60 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7,943.28 / $10,471.29 / $20,417.38
| Facility | | $7,943.28 | $10,471.29 | $20,417.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,023.29 / $1,698.24 / $2,398.83
| Professional | | $1,023.29 | $1,698.24 | $2,398.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7,244.36 / $7,244.36 / $7,244.36
| Facility | | $7,244.36 | $7,244.36 | $7,244.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,174.90 / $2,454.71 / $3,162.28
| Professional | | $1,174.90 | $2,454.71 | $3,162.28 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,000.00 / $1,778.28 / $10,471.29
| Facility | | $1,000.00 | $1,778.28 | $10,471.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,148.15 / $1,995.26 / $8,128.31
| Professional | | $1,148.15 | $1,995.26 | $8,128.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,089.30 / $2,454.71 / $3,388.44
| Professional | | $2,089.30 | $2,454.71 | $3,388.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7,244.36 / $7,244.36 / $7,244.36
| Facility | | $7,244.36 | $7,244.36 | $7,244.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,089.30 / $2,398.83 / $3,388.44
| Professional | | $2,089.30 | $2,398.83 | $3,388.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,309.57 / $7,585.78 / $10,964.78
| Facility | | $6,309.57 | $7,585.78 | $10,964.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,230.27 / $1,949.84 / $2,754.23
| Professional | | $1,230.27 | $1,949.84 | $2,754.23 |