- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $263.03 / $4,786.30 / $17,782.79
| Facility | | $263.03 | $4,786.30 | $17,782.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $213.80 / $812.83 / $2,570.40
| Professional | | $213.80 | $812.83 | $2,570.40 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,011.87 / $7,943.28 / $12,589.25
| Facility | | $5,011.87 | $7,943.28 | $12,589.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $371.54 / $1,318.26 / $4,466.84
| Professional | | $371.54 | $1,318.26 | $4,466.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,388.44 / $3,981.07 / $6,309.57
| Facility | | $3,388.44 | $3,981.07 | $6,309.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $316.23 / $977.24 / $4,466.84
| Professional | | $316.23 | $977.24 | $4,466.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $263.03 / $5,888.44 / $10,471.29
| Facility | | $263.03 | $5,888.44 | $10,471.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $467.74 / $724.44 / $3,311.31
| Professional | | $467.74 | $724.44 | $3,311.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $309.03 / $4,073.80 / $8,709.64
| Facility | | $309.03 | $4,073.80 | $8,709.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,000.00 / $1,659.59 / $4,677.35
| Professional | | $1,000.00 | $1,659.59 | $4,677.35 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $70.79
| Professional | | $32.36 | $33.11 | $70.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,248.07 / $5,754.40 / $7,762.47
| Facility | | $5,248.07 | $5,754.40 | $7,762.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $645.65 / $1,778.28 / $4,168.69
| Professional | | $645.65 | $1,778.28 | $4,168.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $389.05 / $1,513.56 / $4,466.84
| Professional | | $389.05 | $1,513.56 | $4,466.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,165.95 / $6,165.95 / $9,120.11
| Facility | | $6,165.95 | $6,165.95 | $9,120.11 |
- Facility/Professional
- Facility
- Modifier
- 52
- Typical Low / Median / Typical High
- $5,011.87 / $5,011.87 / $7,244.36
| Facility | 52 | $5,011.87 | $5,011.87 | $7,244.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $323.59 / $2,187.76 / $8,511.38
| Professional | | $323.59 | $2,187.76 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $537.03 / $537.03 / $3,311.31
| Professional | | $537.03 | $537.03 | $3,311.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $707.95 / $1,862.09 / $7,585.78
| Professional | | $707.95 | $1,862.09 | $7,585.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,897.79 / $7,585.78 / $9,120.11
| Facility | | $4,897.79 | $7,585.78 | $9,120.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $275.42 / $1,000.00 / $3,981.07
| Professional | | $275.42 | $1,000.00 | $3,981.07 |