- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $912.01 / $6,165.95 / $21,379.62
| Facility | | $912.01 | $6,165.95 | $21,379.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $562.34 / $794.33 / $2,511.89
| Professional | | $562.34 | $794.33 | $2,511.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $549.54 / $549.54 / $549.54
| Professional | | $549.54 | $549.54 | $549.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $18,620.87 / $18,620.87 / $18,620.87
| Facility | | $18,620.87 | $18,620.87 | $18,620.87 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9,549.93 / $10,000.00 / $57,543.99
| Facility | | $9,549.93 | $10,000.00 | $57,543.99 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $758.58 / $1,000.00 / $1,479.11
| Professional | | $758.58 | $1,000.00 | $1,479.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $562.34 / $831.76 / $1,380.38
| Professional | | $562.34 | $831.76 | $1,380.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,230.27 / $1,698.24 / $2,137.96
| Professional | | $1,230.27 | $1,698.24 | $2,137.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $588.84 / $1,047.13 / $1,698.24
| Professional | | $588.84 | $1,047.13 | $1,698.24 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,606.93 / $19,498.45 / $35,481.34
| Facility | | $6,606.93 | $19,498.45 | $35,481.34 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $549.54 / $588.84 / $741.31
| Professional | | $549.54 | $588.84 | $741.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $18,620.87 / $18,620.87 / $18,620.87
| Facility | | $18,620.87 | $18,620.87 | $18,620.87 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $724.44 / $3,630.78 / $23,442.29
| Facility | | $724.44 | $3,630.78 | $23,442.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $562.34 / $812.83 / $1,584.89
| Professional | | $562.34 | $812.83 | $1,584.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $977.24 / $1,288.25 / $1,995.26
| Professional | | $977.24 | $1,288.25 | $1,995.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $562.34 / $616.60 / $758.58
| Facility | | $562.34 | $616.60 | $758.58 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $549.54 / $588.84 / $758.58
| Professional | | $549.54 | $588.84 | $758.58 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,019.95 / $6,309.57 / $23,442.29
| Facility | | $3,019.95 | $6,309.57 | $23,442.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $537.03 / $812.83 / $1,412.54
| Professional | | $537.03 | $812.83 | $1,412.54 |