- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $537.03 / $3,801.89 / $10,000.00
| Facility | | $537.03 | $3,801.89 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $323.59 / $1,202.26 / $5,495.41
| Professional | | $323.59 | $1,202.26 | $5,495.41 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,011.87 / $7,943.28 / $12,589.25
| Facility | | $5,011.87 | $7,943.28 | $12,589.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $354.81 / $1,174.90 / $3,801.89
| Professional | | $354.81 | $1,174.90 | $3,801.89 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $524.81 / $1,778.28 / $5,623.41
| Professional | 50 | $524.81 | $1,778.28 | $5,623.41 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,570.40 / $3,019.95 / $4,786.30
| Facility | | $2,570.40 | $3,019.95 | $4,786.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $489.78 / $1,513.56 / $3,467.37
| Professional | | $489.78 | $1,513.56 | $3,467.37 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $331.13 / $2,238.72 / $4,786.30
| Facility | | $331.13 | $2,238.72 | $4,786.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $630.96 / $912.01 / $2,754.23
| Professional | | $630.96 | $912.01 | $2,754.23 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $933.25 / $1,380.38 / $4,168.69
| Professional | 50 | $933.25 | $1,380.38 | $4,168.69 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $416.87 / $6,309.57 / $11,481.54
| Facility | | $416.87 | $6,309.57 | $11,481.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,258.93 / $3,388.44 / $9,120.11
| Professional | | $1,258.93 | $3,388.44 | $9,120.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $1,023.29
| Professional | | $32.36 | $33.11 | $1,023.29 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $691.83 / $8,511.38 / $9,120.11
| Facility | | $691.83 | $8,511.38 | $9,120.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $794.33 / $1,380.38 / $4,466.84
| Professional | | $794.33 | $1,380.38 | $4,466.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $562.34 / $1,202.26 / $3,388.44
| Professional | | $562.34 | $1,202.26 | $3,388.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,165.95 / $8,912.51 / $8,912.51
| Facility | | $6,165.95 | $8,912.51 | $8,912.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $489.78 / $3,630.78 / $11,481.54
| Professional | | $489.78 | $3,630.78 | $11,481.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,380.38 / $1,380.38 / $5,370.32
| Professional | | $1,380.38 | $1,380.38 | $5,370.32 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,380.38 / $2,089.30 / $6,760.83
| Professional | | $1,380.38 | $2,089.30 | $6,760.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,456.54 / $10,232.93 / $12,022.64
| Facility | | $6,456.54 | $10,232.93 | $12,022.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $89.13 / $1,230.27 / $4,786.30
| Professional | | $89.13 | $1,230.27 | $4,786.30 |