- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,981.07 / $10,000.00 / $22,908.68
| Facility | | $3,981.07 | $10,000.00 | $22,908.68 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,096.48 / $1,348.96 / $5,370.32
| Professional | | $1,096.48 | $1,348.96 | $5,370.32 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,918.31 / $11,748.98 / $18,620.87
| Facility | | $6,918.31 | $11,748.98 | $18,620.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,445.44 / $2,187.76 / $4,168.69
| Professional | | $1,445.44 | $2,187.76 | $4,168.69 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $79.43 / $3,801.89 / $7,079.46
| Facility | | $79.43 | $3,801.89 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,202.26 / $1,778.28 / $3,890.45
| Professional | | $1,202.26 | $1,778.28 | $3,890.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,174.90 / $1,445.44 / $3,162.28
| Professional | | $1,174.90 | $1,445.44 | $3,162.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,047.13 / $1,096.48 / $1,412.54
| Professional | | $1,047.13 | $1,096.48 | $1,412.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $912.01 / $1,174.90 / $2,290.87
| Professional | | $912.01 | $1,174.90 | $2,290.87 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $54.95 / $56.23 / $6,918.31
| Facility | | $54.95 | $56.23 | $6,918.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8,709.64 / $9,549.93 / $9,549.93
| Professional | | $8,709.64 | $9,549.93 | $9,549.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,659.59 / $1,659.59 / $1,659.59
| Professional | | $1,659.59 | $1,659.59 | $1,659.59 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,174.90 / $1,584.89 / $2,511.89
| Facility | | $1,174.90 | $1,584.89 | $2,511.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,148.15 / $1,445.44 / $3,162.28
| Professional | | $1,148.15 | $1,445.44 | $3,162.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,548.13 / $3,548.13 / $3,548.13
| Professional | | $3,548.13 | $3,548.13 | $3,548.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $954.99 / $1,548.82 / $2,344.23
| Professional | | $954.99 | $1,548.82 | $2,344.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,949.84 / $6,165.95 / $18,620.87
| Facility | | $1,949.84 | $6,165.95 | $18,620.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $954.99 / $1,412.54 / $3,162.28
| Professional | | $954.99 | $1,412.54 | $3,162.28 |