- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $407.38 / $870.96 / $14,454.40
| Facility | | $407.38 | $870.96 | $14,454.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $380.19 / $416.87 / $1,047.13
| Professional | | $380.19 | $416.87 | $1,047.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,011.87 / $7,943.28 / $12,589.25
| Facility | | $5,011.87 | $7,943.28 | $12,589.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $457.09 / $794.33 / $2,344.23
| Professional | | $457.09 | $794.33 | $2,344.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,096.48 / $1,288.25 / $2,137.96
| Facility | | $1,096.48 | $1,288.25 | $2,137.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $588.84 / $1,698.24 / $1,949.84
| Professional | | $588.84 | $1,698.24 | $1,949.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $407.38 / $870.96 / $5,754.40
| Facility | | $407.38 | $870.96 | $5,754.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $758.58 / $1,023.29 / $1,318.26
| Professional | | $758.58 | $1,023.29 | $1,318.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $407.38 / $912.01 / $11,481.54
| Facility | | $407.38 | $912.01 | $11,481.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $501.19 / $870.96 / $3,235.94
| Professional | | $501.19 | $870.96 | $3,235.94 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $70.79
| Professional | | $32.36 | $33.11 | $70.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $954.99 / $8,511.38 / $9,120.11
| Facility | | $954.99 | $8,511.38 | $9,120.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $524.81 / $1,096.48 / $1,862.09
| Professional | | $524.81 | $1,096.48 | $1,862.09 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $588.84 / $891.25 / $1,318.26
| Professional | | $588.84 | $891.25 | $1,318.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,235.94 / $6,025.60 / $8,912.51
| Facility | | $3,235.94 | $6,025.60 | $8,912.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $741.31 / $2,290.87 / $3,311.31
| Professional | | $741.31 | $2,290.87 | $3,311.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,380.38 / $1,380.38 / $1,380.38
| Professional | | $1,380.38 | $1,380.38 | $1,380.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,202.26 / $2,630.27 / $2,951.21
| Professional | | $1,202.26 | $2,630.27 | $2,951.21 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,309.57 / $10,000.00 / $12,022.64
| Facility | | $6,309.57 | $10,000.00 | $12,022.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $457.09 / $691.83 / $1,905.46
| Professional | | $457.09 | $691.83 | $1,905.46 |