- 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
- $977.24 / $1,174.90 / $4,897.79
| Professional | | $977.24 | $1,174.90 | $4,897.79 |
- 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
- $1,348.96 / $1,862.09 / $3,630.78
| Professional | | $1,348.96 | $1,862.09 | $3,630.78 |
- 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
- $1,047.13 / $1,548.82 / $3,311.31
| Professional | | $1,047.13 | $1,548.82 | $3,311.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,023.29 / $1,318.26 / $2,884.03
| Professional | | $1,023.29 | $1,318.26 | $2,884.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $870.96 / $933.25 / $1,258.93
| Professional | | $870.96 | $933.25 | $1,258.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $794.33 / $1,023.29 / $1,995.26
| Professional | | $794.33 | $1,023.29 | $1,995.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $54.95 / $56.23 / $5,888.44
| Facility | | $54.95 | $56.23 | $5,888.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10,471.29 / $10,471.29 / $10,471.29
| Professional | | $10,471.29 | $10,471.29 | $10,471.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,445.44 / $1,445.44 / $1,445.44
| Professional | | $1,445.44 | $1,445.44 | $1,445.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,023.29 / $1,412.54 / $2,290.87
| Facility | | $1,023.29 | $1,412.54 | $2,290.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,000.00 / $1,318.26 / $2,884.03
| Professional | | $1,000.00 | $1,318.26 | $2,884.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,090.30 / $3,090.30 / $3,090.30
| Professional | | $3,090.30 | $3,090.30 | $3,090.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $851.14 / $1,202.26 / $1,862.09
| Professional | | $851.14 | $1,202.26 | $1,862.09 |
- 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
- $831.76 / $1,230.27 / $2,754.23
| Professional | | $831.76 | $1,230.27 | $2,754.23 |