- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,148.15 / $6,456.54 / $26,915.35
| Facility | | $1,148.15 | $6,456.54 | $26,915.35 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $602.56 / $1,047.13 / $3,311.31
| Professional | | $602.56 | $1,047.13 | $3,311.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7,079.46 / $19,054.61 / $38,904.51
| Facility | | $7,079.46 | $19,054.61 | $38,904.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $891.25 / $1,445.44 / $2,454.71
| Professional | | $891.25 | $1,445.44 | $2,454.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,000.00 / $1,071.52 / $10,715.19
| Facility | | $1,000.00 | $1,071.52 | $10,715.19 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $691.83 / $1,318.26 / $2,691.53
| Professional | | $691.83 | $1,318.26 | $2,691.53 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $776.25 / $1,288.25 / $8,128.31
| Facility | | $776.25 | $1,288.25 | $8,128.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $758.58 / $1,258.93 / $3,090.30
| Professional | | $758.58 | $1,258.93 | $3,090.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $33.11
| Professional | | $32.36 | $33.11 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,148.15 / $1,949.84 / $1,995.26
| Facility | | $1,148.15 | $1,949.84 | $1,995.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,348.96 / $1,380.38 / $2,818.38
| Facility | | $1,348.96 | $1,380.38 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $831.76 / $1,380.38 / $2,511.89
| Professional | | $831.76 | $1,380.38 | $2,511.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13,182.57 / $19,952.62 / $38,904.51
| Facility | | $13,182.57 | $19,952.62 | $38,904.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $870.96 / $1,445.44 / $2,398.83
| Professional | | $870.96 | $1,445.44 | $2,398.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,951.21 / $20,892.96 / $41,686.94
| Facility | | $2,951.21 | $20,892.96 | $41,686.94 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $758.58 / $1,174.90 / $2,290.87
| Professional | | $758.58 | $1,174.90 | $2,290.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $616.60 / $1,174.90 / $1,513.56
| Professional | | $616.60 | $1,174.90 | $1,513.56 |