- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,041.74 / $12,589.25 / $32,359.37
| Facility | | $2,041.74 | $12,589.25 | $32,359.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $933.25 / $1,621.81 / $5,754.40
| Professional | | $933.25 | $1,621.81 | $5,754.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $190.55 / $1,318.26 / $2,818.38
| Professional | | $190.55 | $1,318.26 | $2,818.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13,803.84 / $19,054.61 / $38,904.51
| Facility | | $13,803.84 | $19,054.61 | $38,904.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,479.11 / $2,089.30 / $2,951.21
| Professional | | $1,479.11 | $2,089.30 | $2,951.21 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,000.00 / $1,737.80 / $10,000.00
| Facility | | $1,000.00 | $1,737.80 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,047.13 / $1,778.28 / $3,235.94
| Professional | | $1,047.13 | $1,778.28 | $3,235.94 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,148.15 / $2,187.76 / $8,709.64
| Facility | | $1,148.15 | $2,187.76 | $8,709.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,096.48 / $2,089.30 / $6,606.93
| Professional | | $1,096.48 | $2,089.30 | $6,606.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $436.52
| Professional | | $32.36 | $33.11 | $436.52 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,479.11 / $2,041.74 / $2,137.96
| Facility | | $1,479.11 | $2,041.74 | $2,137.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,445.44 / $1,479.11 / $2,187.76
| Facility | | $1,445.44 | $1,479.11 | $2,187.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,479.11 / $2,137.96 / $2,818.38
| Professional | | $1,479.11 | $2,137.96 | $2,818.38 |
- 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
- $1,479.11 / $2,089.30 / $2,884.03
| Professional | | $1,479.11 | $2,089.30 | $2,884.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,677.35 / $20,892.96 / $41,686.94
| Facility | | $4,677.35 | $20,892.96 | $41,686.94 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,071.52 / $1,548.82 / $2,818.38
| Professional | | $1,071.52 | $1,548.82 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,071.52 / $1,122.02 / $2,041.74
| Professional | | $1,071.52 | $1,122.02 | $2,041.74 |