- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,089.30 / $10,232.93 / $21,877.62
| Facility | | $2,089.30 | $10,232.93 | $21,877.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,000.00 / $1,412.54 / $4,168.69
| Professional | | $1,000.00 | $1,412.54 | $4,168.69 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $26,302.68 / $34,673.69 / $70,794.58
| Facility | | $26,302.68 | $34,673.69 | $70,794.58 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,513.56 / $2,187.76 / $3,019.95
| Professional | | $1,513.56 | $2,187.76 | $3,019.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $707.95 / $870.96 / $19,054.61
| Facility | | $707.95 | $870.96 | $19,054.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,096.48 / $1,819.70 / $3,311.31
| Professional | | $1,096.48 | $1,819.70 | $3,311.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,174.90 / $2,290.87 / $16,218.10
| Facility | | $1,174.90 | $2,290.87 | $16,218.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,096.48 / $2,187.76 / $12,302.69
| Professional | | $1,096.48 | $2,187.76 | $12,302.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $501.19
| Professional | | $32.36 | $33.11 | $501.19 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,318.26 / $2,137.96 / $2,238.72
| Facility | | $1,318.26 | $2,137.96 | $2,238.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,479.11 / $1,513.56 / $4,365.16
| Facility | | $1,479.11 | $1,513.56 | $4,365.16 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,513.56 / $2,238.72 / $2,884.03
| Professional | | $1,513.56 | $2,238.72 | $2,884.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $23,988.33 / $36,307.81 / $70,794.58
| Facility | | $23,988.33 | $36,307.81 | $70,794.58 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,513.56 / $2,187.76 / $3,019.95
| Professional | | $1,513.56 | $2,187.76 | $3,019.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,467.37 / $37,153.52 / $72,443.60
| Facility | | $3,467.37 | $37,153.52 | $72,443.60 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,122.02 / $1,584.89 / $2,884.03
| Professional | | $1,122.02 | $1,584.89 | $2,884.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,122.02 / $1,202.26 / $2,137.96
| Professional | | $1,122.02 | $1,202.26 | $2,137.96 |