- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,348.96 / $3,630.78 / $9,549.93
| Facility | | $1,348.96 | $3,630.78 | $9,549.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,071.52 / $1,318.26 / $2,290.87
| Professional | | $1,071.52 | $1,318.26 | $2,290.87 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9,772.37 / $12,302.69 / $17,782.79
| Facility | | $9,772.37 | $12,302.69 | $17,782.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,023.29 / $1,348.96 / $1,905.46
| Professional | | $1,023.29 | $1,348.96 | $1,905.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,148.15 / $1,288.25 / $1,949.84
| Professional | | $1,148.15 | $1,288.25 | $1,949.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,122.02 / $1,445.44 / $2,041.74
| Professional | | $1,122.02 | $1,445.44 | $2,041.74 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,000.00 / $1,202.26 / $1,479.11
| Professional | | $1,000.00 | $1,202.26 | $1,479.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,513.56 / $1,905.46 / $2,511.89
| Professional | | $1,513.56 | $1,905.46 | $2,511.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,148.15 / $1,584.89 / $2,290.87
| Facility | | $1,148.15 | $1,584.89 | $2,290.87 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,023.29 / $1,479.11 / $10,000.00
| Facility | | $1,023.29 | $1,479.11 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,023.29 / $1,479.11 / $10,000.00
| Professional | | $1,023.29 | $1,479.11 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,584.89 / $3,311.31 / $6,309.57
| Facility | | $1,584.89 | $3,311.31 | $6,309.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $954.99 / $1,479.11 / $2,344.23
| Professional | | $954.99 | $1,479.11 | $2,344.23 |