- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $478.63 / $3,090.30 / $16,595.87
| Facility | | $478.63 | $3,090.30 | $16,595.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $467.74 / $691.83 / $2,089.30
| Professional | | $467.74 | $691.83 | $2,089.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,011.87 / $8,317.64 / $13,489.63
| Facility | | $5,011.87 | $8,317.64 | $13,489.63 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $660.69 / $1,096.48 / $2,691.53
| Professional | | $660.69 | $1,096.48 | $2,691.53 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,862.09 / $2,187.76 / $3,467.37
| Facility | | $1,862.09 | $2,187.76 | $3,467.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $707.95 / $1,621.81 / $3,311.31
| Professional | | $707.95 | $1,621.81 | $3,311.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $537.03 / $977.24 / $3,548.13
| Facility | | $537.03 | $977.24 | $3,548.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $912.01 / $1,318.26 / $1,995.26
| Professional | | $912.01 | $1,318.26 | $1,995.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $549.54 / $1,023.29 / $10,471.29
| Facility | | $549.54 | $1,023.29 | $10,471.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $758.58 / $1,548.82 / $5,248.07
| Professional | | $758.58 | $1,548.82 | $5,248.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $794.33
| Professional | | $32.36 | $33.11 | $794.33 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,230.27 / $8,511.38 / $9,120.11
| Facility | | $1,230.27 | $8,511.38 | $9,120.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $870.96 / $1,778.28 / $2,454.71
| Professional | | $870.96 | $1,778.28 | $2,454.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $891.25 / $1,513.56 / $2,344.23
| Professional | | $891.25 | $1,513.56 | $2,344.23 |
- 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
- Facility
- Modifier
- AS
- Typical Low / Median / Typical High
- $602.56 / $602.56 / $891.25
| Facility | AS | $602.56 | $602.56 | $891.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $794.33 / $3,548.13 / $5,011.87
| Professional | | $794.33 | $3,548.13 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,584.89 / $1,584.89 / $2,290.87
| Professional | | $1,584.89 | $1,584.89 | $2,290.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,202.26 / $3,162.28 / $4,570.88
| Professional | | $1,202.26 | $3,162.28 | $4,570.88 |
- 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
- $91.20 / $1,348.96 / $3,467.37
| Professional | | $91.20 | $1,348.96 | $3,467.37 |