- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,454.71 / $6,165.95 / $10,232.93
| Facility | | $2,454.71 | $6,165.95 | $10,232.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $912.01 / $1,479.11 / $3,090.30
| Professional | | $912.01 | $1,479.11 | $3,090.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $186.21 / $1,318.26 / $1,949.84
| Professional | | $186.21 | $1,318.26 | $1,949.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,737.80 / $5,370.32 / $15,135.61
| Facility | | $1,737.80 | $5,370.32 | $15,135.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,122.02 / $1,698.24 / $2,398.83
| Professional | | $1,122.02 | $1,698.24 | $2,398.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,258.93 / $1,479.11 / $2,089.30
| Facility | | $1,258.93 | $1,479.11 | $2,089.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $977.24 / $1,258.93 / $1,479.11
| Professional | | $977.24 | $1,258.93 | $1,479.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,168.69 / $7,244.36 / $10,000.00
| Facility | | $4,168.69 | $7,244.36 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,096.48 / $1,698.24 / $2,818.38
| Professional | | $1,096.48 | $1,698.24 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,096.48 / $1,621.81 / $3,981.07
| Professional | | $1,096.48 | $1,621.81 | $3,981.07 |
- Facility/Professional
- Professional
- Modifier
- 22
- Typical Low / Median / Typical High
- $3,162.28 / $3,162.28 / $3,162.28
| Professional | 22 | $3,162.28 | $3,162.28 | $3,162.28 |
- Facility/Professional
- Professional
- Modifier
- 80
- Typical Low / Median / Typical High
- $85.11 / $85.11 / $85.11
| Professional | 80 | $85.11 | $85.11 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- AS
- Typical Low / Median / Typical High
- $41.69 / $41.69 / $41.69
| Professional | AS | $41.69 | $41.69 | $41.69 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10,000.00 / $10,000.00 / $18,197.01
| Facility | | $10,000.00 | $10,000.00 | $18,197.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,047.13 / $1,862.09 / $2,238.72
| Professional | | $1,047.13 | $1,862.09 | $2,238.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,754.23 / $7,244.36 / $17,378.01
| Facility | | $2,754.23 | $7,244.36 | $17,378.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $933.25 / $1,445.44 / $2,398.83
| Professional | | $933.25 | $1,445.44 | $2,398.83 |