- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,230.27 / $1,995.26 / $14,454.40
| Facility | | $1,230.27 | $1,995.26 | $14,454.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $954.99 / $1,318.26 / $3,467.37
| Professional | | $954.99 | $1,318.26 | $3,467.37 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11,748.98 / $16,218.10 / $26,302.68
| Facility | | $11,748.98 | $16,218.10 | $26,302.68 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $977.24 / $1,905.46 / $8,511.38
| Professional | | $977.24 | $1,905.46 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,511.89 / $2,951.21 / $4,677.35
| Facility | | $2,511.89 | $2,951.21 | $4,677.35 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,584.89 / $3,090.30 / $3,981.07
| Professional | | $1,584.89 | $3,090.30 | $3,981.07 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,148.15 / $7,413.10 / $14,454.40
| Facility | | $1,148.15 | $7,413.10 | $14,454.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,089.30 / $2,570.40 / $3,019.95
| Professional | | $2,089.30 | $2,570.40 | $3,019.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,148.15 / $3,388.44 / $9,549.93
| Facility | | $1,148.15 | $3,388.44 | $9,549.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,174.90 / $3,311.31 / $7,943.28
| Professional | | $1,174.90 | $3,311.31 | $7,943.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $64.57 / $1,380.38
| Professional | | $32.36 | $64.57 | $1,380.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,344.23 / $3,235.94 / $4,466.84
| Professional | | $2,344.23 | $3,235.94 | $4,466.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,380.38 / $2,187.76 / $4,168.69
| Professional | | $1,380.38 | $2,187.76 | $4,168.69 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,511.89 / $10,000.00 / $10,000.00
| Facility | | $2,511.89 | $10,000.00 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,698.24 / $4,897.79 / $15,135.61
| Professional | | $1,698.24 | $4,897.79 | $15,135.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5,128.61 / $5,128.61 / $5,128.61
| Professional | | $5,128.61 | $5,128.61 | $5,128.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5,495.41 / $6,760.83 / $7,079.46
| Professional | | $5,495.41 | $6,760.83 | $7,079.46 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,290.87 / $7,079.46 / $19,498.45
| Facility | | $2,290.87 | $7,079.46 | $19,498.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,122.02 / $2,187.76 / $5,011.87
| Professional | | $1,122.02 | $2,187.76 | $5,011.87 |