- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,981.07 / $10,000.00 / $24,547.09
| Facility | | $3,981.07 | $10,000.00 | $24,547.09 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,000.00 / $1,202.26 / $6,025.60
| Professional | | $1,000.00 | $1,202.26 | $6,025.60 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,025.60 / $10,471.29 / $17,782.79
| Facility | | $6,025.60 | $10,471.29 | $17,782.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,230.27 / $1,621.81 / $3,311.31
| Professional | | $1,230.27 | $1,621.81 | $3,311.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $83.18 / $6,165.95 / $10,715.19
| Facility | | $83.18 | $6,165.95 | $10,715.19 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,071.52 / $1,548.82 / $3,090.30
| Professional | | $1,071.52 | $1,548.82 | $3,090.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,071.52 / $1,380.38 / $2,884.03
| Professional | | $1,071.52 | $1,380.38 | $2,884.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $758.58 / $1,174.90 / $1,584.89
| Professional | | $758.58 | $1,174.90 | $1,584.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $933.25 / $1,258.93 / $2,454.71
| Professional | | $933.25 | $1,258.93 | $2,454.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $54.95 / $56.23 / $53,703.18
| Facility | | $54.95 | $56.23 | $53,703.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7,943.28 / $9,549.93 / $9,549.93
| Professional | | $7,943.28 | $9,549.93 | $9,549.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,584.89 / $1,584.89 / $1,584.89
| Professional | | $1,584.89 | $1,584.89 | $1,584.89 |
- 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
- $1,071.52 / $1,380.38 / $2,187.76
| Facility | | $1,071.52 | $1,380.38 | $2,187.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,071.52 / $1,412.54 / $2,884.03
| Professional | | $1,071.52 | $1,412.54 | $2,884.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,548.13 / $3,548.13 / $3,548.13
| Professional | | $3,548.13 | $3,548.13 | $3,548.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $933.25 / $1,148.15 / $1,621.81
| Professional | | $933.25 | $1,148.15 | $1,621.81 |
- 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
- $870.96 / $1,174.90 / $2,570.40
| Professional | | $870.96 | $1,174.90 | $2,570.40 |