- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,248.07 / $11,220.18 / $31,622.78
| Facility | | $5,248.07 | $11,220.18 | $31,622.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $436.52 / $1,778.28 / $4,365.16
| Professional | | $436.52 | $1,778.28 | $4,365.16 |
- Facility/Professional
- Professional
- Modifier
- AS
- Typical Low / Median / Typical High
- $165.96 / $331.13 / $870.96
| Professional | AS | $165.96 | $331.13 | $870.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,606.93 / $30,902.95 / $41,686.94
| Facility | | $6,606.93 | $30,902.95 | $41,686.94 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,318.26 / $2,691.53 / $4,073.80
| Professional | | $1,318.26 | $2,691.53 | $4,073.80 |
- Facility/Professional
- Professional
- Modifier
- AS
- Typical Low / Median / Typical High
- $181.97 / $380.19 / $562.34
| Professional | AS | $181.97 | $380.19 | $562.34 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $851.14 / $25,703.96 / $26,302.68
| Facility | | $851.14 | $25,703.96 | $26,302.68 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,445.44 / $2,398.83 / $3,715.35
| Professional | | $1,445.44 | $2,398.83 | $3,715.35 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $22,908.68 / $23,988.33 / $25,118.86
| Facility | | $22,908.68 | $23,988.33 | $25,118.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,380.38 / $2,344.23 / $6,025.60
| Professional | | $1,380.38 | $2,344.23 | $6,025.60 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10,232.93 / $10,964.78 / $19,054.61
| Facility | | $10,232.93 | $10,964.78 | $19,054.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $338.84 / $2,630.27 / $3,235.94
| Professional | | $338.84 | $2,630.27 | $3,235.94 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9,332.54 / $21,379.62 / $33,884.42
| Facility | | $9,332.54 | $21,379.62 | $33,884.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,202.26 / $2,511.89 / $6,025.60
| Professional | | $1,202.26 | $2,511.89 | $6,025.60 |
- Facility/Professional
- Professional
- Modifier
- AS
- Typical Low / Median / Typical High
- $660.69 / $660.69 / $660.69
| Professional | AS | $660.69 | $660.69 | $660.69 |