- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $398.11 / $1,479.11 / $6,456.54
| Facility | | $398.11 | $1,479.11 | $6,456.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $323.59 / $1,000.00 / $2,238.72
| Professional | | $323.59 | $1,000.00 | $2,238.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,606.93 / $10,964.78 / $17,378.01
| Facility | | $6,606.93 | $10,964.78 | $17,378.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $549.54 / $1,659.59 / $5,128.61
| Professional | | $549.54 | $1,659.59 | $5,128.61 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,019.95 / $3,548.13 / $5,623.41
| Facility | | $3,019.95 | $3,548.13 | $5,623.41 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $645.65 / $1,122.02 / $4,073.80
| Professional | | $645.65 | $1,122.02 | $4,073.80 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $346.74 / $3,162.28 / $5,754.40
| Facility | | $346.74 | $3,162.28 | $5,754.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $758.58 / $1,071.52 / $3,235.94
| Professional | | $758.58 | $1,071.52 | $3,235.94 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $346.74 / $7,943.28 / $15,135.61
| Facility | | $346.74 | $7,943.28 | $15,135.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,258.93 / $2,818.38 / $7,244.36
| Professional | | $1,258.93 | $2,818.38 | $7,244.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $50.12 / $1,584.89
| Professional | | $32.36 | $50.12 | $1,584.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $660.69 / $10,715.19 / $17,378.01
| Facility | | $660.69 | $10,715.19 | $17,378.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $891.25 / $1,584.89 / $4,073.80
| Professional | | $891.25 | $1,584.89 | $4,073.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $724.44 / $1,412.54 / $4,365.16
| Professional | | $724.44 | $1,412.54 | $4,365.16 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $20,417.38 / $30,199.52 / $30,199.52
| Facility | | $20,417.38 | $30,199.52 | $30,199.52 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $588.84 / $4,265.80 / $7,762.47
| Professional | | $588.84 | $4,265.80 | $7,762.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,621.81 / $1,621.81 / $6,309.57
| Professional | | $1,621.81 | $1,621.81 | $6,309.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,698.24 / $5,248.07 / $7,943.28
| Professional | | $1,698.24 | $5,248.07 | $7,943.28 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8,912.51 / $14,125.38 / $17,378.01
| Facility | | $8,912.51 | $14,125.38 | $17,378.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $426.58 / $1,380.38 / $5,011.87
| Professional | | $426.58 | $1,380.38 | $5,011.87 |