- 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
- $1,288.25 / $1,584.89 / $5,888.44
| Professional | | $1,288.25 | $1,584.89 | $5,888.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,025.60 / $10,471.29 / $17,782.79
| Facility | | $6,025.60 | $10,471.29 | $17,782.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,737.80 / $2,511.89 / $4,786.30
| Professional | | $1,737.80 | $2,511.89 | $4,786.30 |
- 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
- $1,096.48 / $1,659.59 / $3,890.45
| Professional | | $1,096.48 | $1,659.59 | $3,890.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,318.26 / $1,659.59 / $3,630.78
| Professional | | $1,318.26 | $1,659.59 | $3,630.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,202.26 / $1,230.27 / $1,659.59
| Professional | | $1,202.26 | $1,230.27 | $1,659.59 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,071.52 / $1,380.38 / $2,630.27
| Professional | | $1,071.52 | $1,380.38 | $2,630.27 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $54.95 / $56.23 / $7,943.28
| Facility | | $54.95 | $56.23 | $7,943.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11,481.54 / $11,481.54 / $11,481.54
| Professional | | $11,481.54 | $11,481.54 | $11,481.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,949.84 / $1,949.84 / $1,949.84
| Professional | | $1,949.84 | $1,949.84 | $1,949.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,380.38 / $1,778.28 / $2,511.89
| Facility | | $1,380.38 | $1,778.28 | $2,511.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,288.25 / $1,659.59 / $3,548.13
| Professional | | $1,288.25 | $1,659.59 | $3,548.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4,168.69 / $4,168.69 / $4,168.69
| Professional | | $4,168.69 | $4,168.69 | $4,168.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,122.02 / $1,659.59 / $2,570.40
| Professional | | $1,122.02 | $1,659.59 | $2,570.40 |
- 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
- $1,122.02 / $1,621.81 / $3,630.78
| Professional | | $1,122.02 | $1,621.81 | $3,630.78 |