- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,000.00 / $3,715.35 / $11,748.98
| Facility | | $1,000.00 | $3,715.35 | $11,748.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,148.15 / $1,348.96 / $2,290.87
| Professional | | $1,148.15 | $1,348.96 | $2,290.87 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8,128.31 / $18,620.87 / $35,481.34
| Facility | | $8,128.31 | $18,620.87 | $35,481.34 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,174.90 / $1,445.44 / $1,995.26
| Professional | | $1,174.90 | $1,445.44 | $1,995.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $79.43 / $1,148.15 / $1,174.90
| Facility | | $79.43 | $1,148.15 | $1,174.90 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,187.76 / $2,187.76 / $2,187.76
| Facility | | $2,187.76 | $2,187.76 | $2,187.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,202.26 / $1,698.24 / $2,691.53
| Professional | | $1,202.26 | $1,698.24 | $2,691.53 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,238.72 / $33,884.42 / $48,977.88
| Facility | | $2,238.72 | $33,884.42 | $48,977.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9,332.54 / $10,964.78 / $10,964.78
| Professional | | $9,332.54 | $10,964.78 | $10,964.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,122.02 / $1,862.09 / $6,025.60
| Facility | | $1,122.02 | $1,862.09 | $6,025.60 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,174.90 / $1,659.59 / $2,884.03
| Professional | | $1,174.90 | $1,659.59 | $2,884.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $1,174.90
| Professional | | $32.36 | $33.11 | $1,174.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,513.56 / $4,265.80 / $4,570.88
| Professional | | $1,513.56 | $4,265.80 | $4,570.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,174.90 / $1,621.81 / $2,754.23
| Facility | | $1,174.90 | $1,621.81 | $2,754.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,174.90 / $1,698.24 / $2,630.27
| Professional | | $1,174.90 | $1,698.24 | $2,630.27 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,754.23 / $8,128.31 / $16,218.10
| Facility | | $2,754.23 | $8,128.31 | $16,218.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,023.29 / $1,380.38 / $2,137.96
| Professional | | $1,023.29 | $1,380.38 | $2,137.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,148.15 / $1,148.15 / $1,230.27
| Professional | | $1,148.15 | $1,148.15 | $1,230.27 |