- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,454.71 / $3,890.45 / $10,964.78
| Facility | | $2,454.71 | $3,890.45 | $10,964.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,137.96 / $2,754.23 / $7,079.46
| Professional | | $2,137.96 | $2,754.23 | $7,079.46 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,011.87 / $10,964.78 / $19,054.61
| Facility | | $5,011.87 | $10,964.78 | $19,054.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,778.28 / $2,344.23 / $5,754.40
| Professional | | $1,778.28 | $2,344.23 | $5,754.40 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,019.95 / $3,019.95 / $37,153.52
| Facility | | $3,019.95 | $3,019.95 | $37,153.52 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,019.95 / $3,019.95 / $3,019.95
| Professional | | $3,019.95 | $3,019.95 | $3,019.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $34.67 / $5,754.40 / $53,703.18
| Facility | | $34.67 | $5,754.40 | $53,703.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,089.30 / $4,073.80 / $10,000.00
| Professional | | $2,089.30 | $4,073.80 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,187.76 / $3,019.95 / $7,943.28
| Facility | | $2,187.76 | $3,019.95 | $7,943.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,137.96 / $3,235.94 / $4,570.88
| Professional | | $2,137.96 | $3,235.94 | $4,570.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,479.11 / $2,511.89 / $3,890.45
| Professional | | $1,479.11 | $2,511.89 | $3,890.45 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,089.30 / $50,118.72 / $75,857.76
| Facility | | $2,089.30 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $398.11 / $2,818.38 / $3,467.37
| Professional | | $398.11 | $2,818.38 | $3,467.37 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,479.11 / $4,073.80 / $9,332.54
| Facility | | $1,479.11 | $4,073.80 | $9,332.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,949.84 / $2,951.21 / $7,585.78
| Professional | | $1,949.84 | $2,951.21 | $7,585.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,737.80 / $2,691.53 / $6,309.57
| Facility | | $1,737.80 | $2,691.53 | $6,309.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,479.11 / $2,691.53 / $8,128.31
| Professional | | $1,479.11 | $2,691.53 | $8,128.31 |