- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10,000.00 / $13,803.84 / $22,908.68
| Facility | | $10,000.00 | $13,803.84 | $22,908.68 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7,762.47 / $9,120.11 / $14,454.40
| Facility | | $7,762.47 | $9,120.11 | $14,454.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $812.83 / $1,479.11 / $10,471.29
| Professional | | $812.83 | $1,479.11 | $10,471.29 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $588.84 / $6,918.31 / $13,489.63
| Facility | | $588.84 | $6,918.31 | $13,489.63 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $977.24 / $1,479.11 / $8,128.31
| Professional | | $977.24 | $1,479.11 | $8,128.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $588.84 / $8,709.64 / $16,595.87
| Facility | | $588.84 | $8,709.64 | $16,595.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4,073.80 / $7,244.36 / $18,197.01
| Professional | | $4,073.80 | $7,244.36 | $18,197.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $50.12 / $5,248.07
| Professional | | $32.36 | $50.12 | $5,248.07 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $912.01 / $10,715.19 / $17,378.01
| Facility | | $912.01 | $10,715.19 | $17,378.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,258.93 / $3,981.07 / $12,302.69
| Professional | | $1,258.93 | $3,981.07 | $12,302.69 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14,125.38 / $14,125.38 / $20,417.38
| Facility | | $14,125.38 | $14,125.38 | $20,417.38 |
- Facility/Professional
- Facility
- Modifier
- 53
- Typical Low / Median / Typical High
- $2,818.38 / $2,818.38 / $4,168.69
| Facility | 53 | $2,818.38 | $2,818.38 | $4,168.69 |
- Facility/Professional
- Facility
- Modifier
- AS
- Typical Low / Median / Typical High
- $1,412.54 / $1,412.54 / $2,041.74
| Facility | AS | $1,412.54 | $1,412.54 | $2,041.74 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16,595.87 / $19,952.62 / $19,952.62
| Professional | | $16,595.87 | $19,952.62 | $19,952.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13,489.63 / $14,125.38 / $16,218.10
| Facility | | $13,489.63 | $14,125.38 | $16,218.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $79.43 / $2,511.89 / $3,548.13
| Professional | | $79.43 | $2,511.89 | $3,548.13 |