- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $446.68 / $6,456.54 / $18,620.87
| Facility | | $446.68 | $6,456.54 | $18,620.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $218.78 / $1,122.02 / $4,570.88
| Professional | | $218.78 | $1,122.02 | $4,570.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10,715.19 / $14,791.08 / $29,512.09
| Facility | | $10,715.19 | $14,791.08 | $29,512.09 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $295.12 / $660.69 / $4,677.35
| Professional | | $295.12 | $660.69 | $4,677.35 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $309.03 / $676.08 / $6,025.60
| Professional | | $309.03 | $676.08 | $6,025.60 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $398.11 / $4,466.84 / $19,952.62
| Facility | | $398.11 | $4,466.84 | $19,952.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $398.11 / $3,090.30 / $6,918.31
| Professional | | $398.11 | $3,090.30 | $6,918.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $75.86
| Professional | | $32.36 | $33.11 | $75.86 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,951.21 / $3,715.35 / $5,011.87
| Facility | | $2,951.21 | $3,715.35 | $5,011.87 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,691.53 / $2,884.03 / $2,884.03
| Facility | | $2,691.53 | $2,884.03 | $2,884.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $295.12 / $2,691.53 / $4,897.79
| Professional | | $295.12 | $2,691.53 | $4,897.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10,000.00 / $15,135.61 / $29,512.09
| Facility | | $10,000.00 | $15,135.61 | $29,512.09 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $363.08 / $660.69 / $4,570.88
| Professional | | $363.08 | $660.69 | $4,570.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,128.61 / $17,782.79 / $31,622.78
| Facility | | $5,128.61 | $17,782.79 | $31,622.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $316.23 / $1,905.46 / $5,011.87
| Professional | | $316.23 | $1,905.46 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $218.78 / $380.19 / $4,365.16
| Professional | | $218.78 | $380.19 | $4,365.16 |