- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,737.80 / $2,818.38 / $14,454.40
| Facility | | $1,737.80 | $2,818.38 | $14,454.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,258.93 / $1,737.80 / $4,897.79
| Professional | | $1,258.93 | $1,737.80 | $4,897.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10,000.00 / $13,803.84 / $21,877.62
| Facility | | $10,000.00 | $13,803.84 | $21,877.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,348.96 / $2,630.27 / $7,762.47
| Professional | | $1,348.96 | $2,630.27 | $7,762.47 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,548.13 / $4,073.80 / $6,606.93
| Facility | | $3,548.13 | $4,073.80 | $6,606.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,187.76 / $4,365.16 / $5,495.41
| Professional | | $2,187.76 | $4,365.16 | $5,495.41 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,584.89 / $7,244.36 / $14,454.40
| Facility | | $1,584.89 | $7,244.36 | $14,454.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,951.21 / $3,630.78 / $4,265.80
| Professional | | $2,951.21 | $3,630.78 | $4,265.80 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,584.89 / $3,548.13 / $9,549.93
| Facility | | $1,584.89 | $3,548.13 | $9,549.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,698.24 / $2,951.21 / $7,943.28
| Professional | | $1,698.24 | $2,951.21 | $7,943.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $1,949.84
| Professional | | $32.36 | $33.11 | $1,949.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,041.74 / $2,041.74 / $2,884.03
| Facility | | $2,041.74 | $2,041.74 | $2,884.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,995.26 / $4,073.80 / $6,165.95
| Professional | | $1,995.26 | $4,073.80 | $6,165.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,238.72 / $3,548.13 / $5,888.44
| Professional | | $2,238.72 | $3,548.13 | $5,888.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,548.13 / $41,686.94 / $41,686.94
| Facility | | $3,548.13 | $41,686.94 | $41,686.94 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,398.83 / $6,760.83 / $21,877.62
| Professional | | $2,398.83 | $6,760.83 | $21,877.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7,079.46 / $7,079.46 / $7,079.46
| Professional | | $7,079.46 | $7,079.46 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6,309.57 / $9,549.93 / $9,549.93
| Professional | | $6,309.57 | $9,549.93 | $9,549.93 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,290.87 / $7,079.46 / $19,498.45
| Facility | | $2,290.87 | $7,079.46 | $19,498.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,659.59 / $2,884.03 / $6,165.95
| Professional | | $1,659.59 | $2,884.03 | $6,165.95 |