- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,981.07 / $10,000.00 / $20,892.96
| Facility | | $3,981.07 | $10,000.00 | $20,892.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,187.76 / $2,691.53 / $9,549.93
| Professional | | $2,187.76 | $2,691.53 | $9,549.93 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,918.31 / $11,481.54 / $18,620.87
| Facility | | $6,918.31 | $11,481.54 | $18,620.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,995.26 / $3,019.95 / $6,760.83
| Professional | | $1,995.26 | $3,019.95 | $6,760.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $83.18 / $6,918.31 / $13,182.57
| Facility | | $83.18 | $6,918.31 | $13,182.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,778.28 / $2,511.89 / $5,754.40
| Professional | | $1,778.28 | $2,511.89 | $5,754.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,737.80 / $2,951.21 / $6,456.54
| Professional | | $1,737.80 | $2,951.21 | $6,456.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,318.26 / $2,454.71 / $3,311.31
| Professional | | $1,318.26 | $2,454.71 | $3,311.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,995.26 / $2,691.53 / $5,495.41
| Professional | | $1,995.26 | $2,691.53 | $5,495.41 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $54.95 / $56.23 / $20,892.96
| Facility | | $54.95 | $56.23 | $20,892.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $17,782.79 / $21,379.62 / $21,379.62
| Professional | | $17,782.79 | $21,379.62 | $21,379.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,630.78 / $3,630.78 / $3,630.78
| Professional | | $3,630.78 | $3,630.78 | $3,630.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $54.95 / $54.95 / $70.79
| Professional | | $54.95 | $54.95 | $70.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,041.74 / $2,754.23 / $4,677.35
| Facility | | $2,041.74 | $2,754.23 | $4,677.35 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,737.80 / $2,951.21 / $6,456.54
| Professional | | $1,737.80 | $2,951.21 | $6,456.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8,128.31 / $8,128.31 / $8,128.31
| Professional | | $8,128.31 | $8,128.31 | $8,128.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,659.59 / $2,238.72 / $2,818.38
| Professional | | $1,659.59 | $2,238.72 | $2,818.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7,762.47 / $14,125.38 / $28,840.32
| Facility | | $7,762.47 | $14,125.38 | $28,840.32 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,698.24 / $2,454.71 / $5,623.41
| Professional | | $1,698.24 | $2,454.71 | $5,623.41 |