- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,047.13 / $4,786.30 / $8,317.64
| Facility | | $1,047.13 | $4,786.30 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $173.78 / $1,584.89 / $2,818.38
| Professional | | $173.78 | $1,584.89 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,754.23 / $2,754.23 / $2,754.23
| Professional | | $2,754.23 | $2,754.23 | $2,754.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9,549.93 / $10,000.00 / $57,543.99
| Facility | | $9,549.93 | $10,000.00 | $57,543.99 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,348.96 / $2,818.38 / $3,715.35
| Professional | | $1,348.96 | $2,818.38 | $3,715.35 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $2,290.87 / $4,265.80 / $5,495.41
| Professional | 50 | $2,290.87 | $4,265.80 | $5,495.41 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $194.98 / $354.81 / $3,090.30
| Professional | | $194.98 | $354.81 | $3,090.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,754.23 / $2,754.23 / $2,884.03
| Professional | | $2,754.23 | $2,754.23 | $2,884.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,513.56 / $1,513.56 / $1,513.56
| Facility | | $1,513.56 | $1,513.56 | $1,513.56 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $239.88 / $2,187.76 / $3,388.44
| Professional | | $239.88 | $2,187.76 | $3,388.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7,585.78 / $16,595.87 / $30,199.52
| Facility | | $7,585.78 | $16,595.87 | $30,199.52 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $190.55 / $257.04 / $1,778.28
| Professional | | $190.55 | $257.04 | $1,778.28 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $407.38 / $407.38 / $407.38
| Professional | 50 | $407.38 | $407.38 | $407.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $831.76 / $3,630.78 / $8,317.64
| Facility | | $831.76 | $3,630.78 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $165.96 / $1,548.82 / $2,884.03
| Professional | | $165.96 | $1,548.82 | $2,884.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4,786.30 / $4,786.30 / $4,786.30
| Professional | | $4,786.30 | $4,786.30 | $4,786.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $173.78 / $199.53 / $2,238.72
| Facility | | $173.78 | $199.53 | $2,238.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $165.96 / $199.53 / $1,737.80
| Professional | | $165.96 | $199.53 | $1,737.80 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,019.95 / $6,309.57 / $17,782.79
| Facility | | $3,019.95 | $6,309.57 | $17,782.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $186.21 / $1,288.25 / $3,235.94
| Professional | | $186.21 | $1,288.25 | $3,235.94 |