- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,412.54 / $2,290.87 / $14,454.40
| Facility | | $1,412.54 | $2,290.87 | $14,454.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,023.29 / $1,412.54 / $3,981.07
| Professional | | $1,023.29 | $1,412.54 | $3,981.07 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10,000.00 / $13,803.84 / $22,387.21
| Facility | | $10,000.00 | $13,803.84 | $22,387.21 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,096.48 / $2,137.96 / $6,309.57
| Professional | | $1,096.48 | $2,137.96 | $6,309.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,884.03 / $3,311.31 / $5,370.32
| Facility | | $2,884.03 | $3,311.31 | $5,370.32 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,778.28 / $3,548.13 / $4,466.84
| Professional | | $1,778.28 | $3,548.13 | $4,466.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,288.25 / $7,244.36 / $14,454.40
| Facility | | $1,288.25 | $7,244.36 | $14,454.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,398.83 / $2,951.21 / $3,467.37
| Professional | | $2,398.83 | $2,951.21 | $3,467.37 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,288.25 / $14,125.38 / $23,442.29
| Facility | | $1,288.25 | $14,125.38 | $23,442.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,348.96 / $2,344.23 / $6,456.54
| Professional | | $1,348.96 | $2,344.23 | $6,456.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $1,548.82
| Professional | | $32.36 | $33.11 | $1,548.82 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,344.23 / $14,454.40 / $40,738.03
| Facility | | $2,344.23 | $14,454.40 | $40,738.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,621.81 / $3,235.94 / $5,011.87
| Professional | | $1,621.81 | $3,235.94 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,819.70 / $2,884.03 / $4,786.30
| Professional | | $1,819.70 | $2,884.03 | $4,786.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,884.03 / $20,892.96 / $20,892.96
| Facility | | $2,884.03 | $20,892.96 | $20,892.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,949.84 / $5,495.41 / $12,022.64
| Professional | | $1,949.84 | $5,495.41 | $12,022.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5,754.40 / $5,754.40 / $5,754.40
| Professional | | $5,754.40 | $5,754.40 | $5,754.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5,128.61 / $7,762.47 / $7,762.47
| Professional | | $5,128.61 | $7,762.47 | $7,762.47 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10,232.93 / $19,498.45 / $25,118.86
| Facility | | $10,232.93 | $19,498.45 | $25,118.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,348.96 / $2,290.87 / $5,011.87
| Professional | | $1,348.96 | $2,290.87 | $5,011.87 |