- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,778.28 / $2,691.53 / $20,892.96
| Facility | | $1,778.28 | $2,691.53 | $20,892.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $954.99 / $1,202.26 / $2,344.23
| Professional | | $954.99 | $1,202.26 | $2,344.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10,715.19 / $14,791.08 / $29,512.09
| Facility | | $10,715.19 | $14,791.08 | $29,512.09 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,348.96 / $1,949.84 / $2,454.71
| Professional | | $1,348.96 | $1,949.84 | $2,454.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,174.90 / $1,905.46 / $2,818.38
| Professional | | $1,174.90 | $1,905.46 | $2,818.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,513.56 / $2,344.23 / $22,908.68
| Facility | | $1,513.56 | $2,344.23 | $22,908.68 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,513.56 / $2,089.30 / $4,677.35
| Professional | | $1,513.56 | $2,089.30 | $4,677.35 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $75.86
| Professional | | $32.36 | $33.11 | $75.86 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,584.89 / $1,819.70 / $2,041.74
| Facility | | $1,584.89 | $1,819.70 | $2,041.74 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,318.26 / $1,318.26 / $1,318.26
| Facility | | $1,318.26 | $1,318.26 | $1,318.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,318.26 / $1,995.26 / $2,754.23
| Professional | | $1,318.26 | $1,995.26 | $2,754.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10,000.00 / $15,135.61 / $29,512.09
| Facility | | $10,000.00 | $15,135.61 | $29,512.09 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,348.96 / $1,905.46 / $2,454.71
| Professional | | $1,348.96 | $1,905.46 | $2,454.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,128.61 / $18,620.87 / $33,113.11
| Facility | | $5,128.61 | $18,620.87 | $33,113.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,047.13 / $1,479.11 / $2,570.40
| Professional | | $1,047.13 | $1,479.11 | $2,570.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,000.00 / $1,174.90 / $1,778.28
| Professional | | $1,000.00 | $1,174.90 | $1,778.28 |