- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,122.02 / $4,677.35 / $8,511.38
| Facility | | $1,122.02 | $4,677.35 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $389.05 / $1,202.26 / $2,089.30
| Professional | | $389.05 | $1,202.26 | $2,089.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,456.54 / $7,585.78 / $57,543.99
| Facility | | $6,456.54 | $7,585.78 | $57,543.99 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,000.00 / $1,584.89 / $2,290.87
| Professional | | $1,000.00 | $1,584.89 | $2,290.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $371.54 / $741.31 / $2,187.76
| Professional | | $371.54 | $741.31 | $2,187.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,238.72 / $2,238.72 / $2,344.23
| Professional | | $2,238.72 | $2,238.72 | $2,344.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $512.86 / $1,698.24 / $2,691.53
| Professional | | $512.86 | $1,698.24 | $2,691.53 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8,709.64 / $14,125.38 / $14,125.38
| Facility | | $8,709.64 | $14,125.38 | $14,125.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $954.99 / $954.99 / $954.99
| Professional | | $954.99 | $954.99 | $954.99 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $831.76 / $3,630.78 / $7,244.36
| Facility | | $831.76 | $3,630.78 | $7,244.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $389.05 / $1,148.15 / $2,137.96
| Professional | | $389.05 | $1,148.15 | $2,137.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,659.59 / $1,778.28 / $3,388.44
| Professional | | $1,659.59 | $1,778.28 | $3,388.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $371.54 / $954.99 / $3,311.31
| Facility | | $371.54 | $954.99 | $3,311.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $354.81 / $380.19 / $1,288.25
| Professional | | $354.81 | $380.19 | $1,288.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,137.96 / $4,570.88 / $10,232.93
| Facility | | $2,137.96 | $4,570.88 | $10,232.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $380.19 / $1,096.48 / $2,137.96
| Professional | | $380.19 | $1,096.48 | $2,137.96 |