- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,995.26 / $7,244.36 / $19,952.62
| Facility | | $1,995.26 | $7,244.36 | $19,952.62 |
- Facility/Professional
- Facility
- Modifier
- 80
- Typical Low / Median / Typical High
- $11,220.18 / $11,220.18 / $11,220.18
| Facility | 80 | $11,220.18 | $11,220.18 | $11,220.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $169.82 / $645.65 / $2,344.23
| Professional | | $169.82 | $645.65 | $2,344.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $72.44 / $501.19 / $1,174.90
| Professional | | $72.44 | $501.19 | $1,174.90 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,456.54 / $11,220.18 / $17,782.79
| Facility | | $6,456.54 | $11,220.18 | $17,782.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $691.83 / $1,122.02 / $1,905.46
| Professional | | $691.83 | $1,122.02 | $1,905.46 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $85.11 / $6,606.93 / $11,748.98
| Facility | | $85.11 | $6,606.93 | $11,748.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $616.60 / $891.25 / $1,737.80
| Professional | | $616.60 | $891.25 | $1,737.80 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,090.30 / $8,511.38 / $26,302.68
| Facility | | $3,090.30 | $8,511.38 | $26,302.68 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $602.56 / $794.33 / $1,621.81
| Professional | | $602.56 | $794.33 | $1,621.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $446.68 / $660.69 / $891.25
| Professional | | $446.68 | $660.69 | $891.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $537.03 / $707.95 / $1,318.26
| Professional | | $537.03 | $707.95 | $1,318.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9,332.54 / $9,332.54 / $45,708.82
| Facility | | $9,332.54 | $9,332.54 | $45,708.82 |
- Facility/Professional
- Facility
- Modifier
- AS
- Typical Low / Median / Typical High
- $933.25 / $933.25 / $933.25
| Facility | AS | $933.25 | $933.25 | $933.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4,677.35 / $5,128.61 / $5,128.61
| Professional | | $4,677.35 | $5,128.61 | $5,128.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $851.14 / $851.14 / $851.14
| Professional | | $851.14 | $851.14 | $851.14 |
- 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
- $588.84 / $812.83 / $1,412.54
| Facility | | $588.84 | $812.83 | $1,412.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $602.56 / $794.33 / $1,584.89
| Professional | | $602.56 | $794.33 | $1,584.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,041.74 / $2,041.74 / $2,041.74
| Professional | | $2,041.74 | $2,041.74 | $2,041.74 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $537.03 / $660.69 / $954.99
| Professional | | $537.03 | $660.69 | $954.99 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7,762.47 / $13,803.84 / $28,840.32
| Facility | | $7,762.47 | $13,803.84 | $28,840.32 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $478.63 / $660.69 / $1,548.82
| Professional | | $478.63 | $660.69 | $1,548.82 |