- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,000.00 / $3,715.35 / $11,748.98
| Facility | | $1,000.00 | $3,715.35 | $11,748.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,202.26 / $1,479.11 / $2,754.23
| Professional | | $1,202.26 | $1,479.11 | $2,754.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8,511.38 / $17,782.79 / $34,673.69
| Facility | | $8,511.38 | $17,782.79 | $34,673.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,258.93 / $1,584.89 / $2,137.96
| Professional | | $1,258.93 | $1,584.89 | $2,137.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,230.27 / $8,709.64 / $22,908.68
| Facility | | $1,230.27 | $8,709.64 | $22,908.68 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,348.96 / $1,778.28 / $2,290.87
| Professional | | $1,348.96 | $1,778.28 | $2,290.87 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,230.27 / $16,218.10 / $16,218.10
| Facility | | $1,230.27 | $16,218.10 | $16,218.10 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,344.23 / $2,344.23 / $2,344.23
| Facility | | $2,344.23 | $2,344.23 | $2,344.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,288.25 / $1,819.70 / $2,884.03
| Professional | | $1,288.25 | $1,819.70 | $2,884.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $54.95 / $33,884.42 / $58,884.37
| Facility | | $54.95 | $33,884.42 | $58,884.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10,000.00 / $11,748.98 / $11,748.98
| Professional | | $10,000.00 | $11,748.98 | $11,748.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,202.26 / $1,949.84 / $5,623.41
| Facility | | $1,202.26 | $1,949.84 | $5,623.41 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,258.93 / $1,778.28 / $3,090.30
| Professional | | $1,258.93 | $1,778.28 | $3,090.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $173.78 / $1,174.90
| Professional | | $32.36 | $173.78 | $1,174.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,621.81 / $1,621.81 / $1,621.81
| Professional | | $1,621.81 | $1,621.81 | $1,621.81 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,258.93 / $1,778.28 / $2,951.21
| Facility | | $1,258.93 | $1,778.28 | $2,951.21 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,258.93 / $1,819.70 / $2,818.38
| Professional | | $1,258.93 | $1,819.70 | $2,818.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,754.23 / $8,128.31 / $16,218.10
| Facility | | $2,754.23 | $8,128.31 | $16,218.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,096.48 / $1,479.11 / $2,344.23
| Professional | | $1,096.48 | $1,479.11 | $2,344.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,202.26 / $1,230.27 / $1,318.26
| Professional | | $1,202.26 | $1,230.27 | $1,318.26 |