- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,905.46 / $8,912.51 / $20,892.96
| Facility | | $1,905.46 | $8,912.51 | $20,892.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $912.01 / $1,288.25 / $2,511.89
| Professional | | $912.01 | $1,288.25 | $2,511.89 |
- 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
- $1,380.38 / $1,995.26 / $2,754.23
| Professional | | $1,380.38 | $1,995.26 | $2,754.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,000.00 / $1,230.27 / $19,054.61
| Facility | | $1,000.00 | $1,230.27 | $19,054.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,000.00 / $1,659.59 / $3,019.95
| Professional | | $1,000.00 | $1,659.59 | $3,019.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,047.13 / $2,041.74 / $16,218.10
| Facility | | $1,047.13 | $2,041.74 | $16,218.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,023.29 / $1,995.26 / $12,302.69
| Professional | | $1,023.29 | $1,995.26 | $12,302.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $33.11
| Professional | | $32.36 | $33.11 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,513.56 / $1,905.46 / $1,995.26
| Facility | | $1,513.56 | $1,905.46 | $1,995.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,348.96 / $1,380.38 / $4,365.16
| Facility | | $1,348.96 | $1,380.38 | $4,365.16 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,380.38 / $2,041.74 / $2,630.27
| Professional | | $1,380.38 | $2,041.74 | $2,630.27 |
- 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
- $1,380.38 / $1,995.26 / $2,754.23
| Professional | | $1,380.38 | $1,995.26 | $2,754.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,677.35 / $37,153.52 / $72,443.60
| Facility | | $4,677.35 | $37,153.52 | $72,443.60 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,023.29 / $1,445.44 / $2,630.27
| Professional | | $1,023.29 | $1,445.44 | $2,630.27 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,023.29 / $1,071.52 / $1,905.46
| Professional | | $1,023.29 | $1,071.52 | $1,905.46 |