- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,778.28 / $9,120.11 / $28,183.83
| Facility | | $1,778.28 | $9,120.11 | $28,183.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $691.83 / $1,096.48 / $3,715.35
| Professional | | $691.83 | $1,096.48 | $3,715.35 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13,803.84 / $19,054.61 / $38,904.51
| Facility | | $13,803.84 | $19,054.61 | $38,904.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,096.48 / $1,548.82 / $2,089.30
| Professional | | $1,096.48 | $1,548.82 | $2,089.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $630.96 / $758.58 / $10,000.00
| Facility | | $630.96 | $758.58 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $741.31 / $1,288.25 / $2,290.87
| Professional | | $741.31 | $1,288.25 | $2,290.87 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $794.33 / $1,548.82 / $8,128.31
| Facility | | $794.33 | $1,548.82 | $8,128.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $741.31 / $1,479.11 / $6,606.93
| Professional | | $741.31 | $1,479.11 | $6,606.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $363.08
| Professional | | $32.36 | $33.11 | $363.08 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,230.27 / $1,479.11 / $1,548.82
| Facility | | $1,230.27 | $1,479.11 | $1,548.82 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,071.52 / $1,096.48 / $2,187.76
| Facility | | $1,071.52 | $1,096.48 | $2,187.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,096.48 / $1,621.81 / $2,089.30
| Professional | | $1,096.48 | $1,621.81 | $2,089.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13,182.57 / $19,952.62 / $38,904.51
| Facility | | $13,182.57 | $19,952.62 | $38,904.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,096.48 / $1,548.82 / $2,089.30
| Professional | | $1,096.48 | $1,548.82 | $2,089.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,137.96 / $20,892.96 / $41,686.94
| Facility | | $2,137.96 | $20,892.96 | $41,686.94 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $758.58 / $1,071.52 / $2,041.74
| Professional | | $758.58 | $1,071.52 | $2,041.74 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $831.76 / $870.96 / $1,584.89
| Professional | | $831.76 | $870.96 | $1,584.89 |