- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,000.00 / $5,754.40 / $15,488.17
| Facility | | $1,000.00 | $5,754.40 | $15,488.17 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $426.58 / $1,445.44 / $9,332.54
| Professional | | $426.58 | $1,445.44 | $9,332.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $281.84 / $562.34 / $3,981.07
| Professional | | $281.84 | $562.34 | $3,981.07 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,137.96 / $8,128.31 / $13,803.84
| Facility | | $2,137.96 | $8,128.31 | $13,803.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $407.38 / $3,548.13 / $4,786.30
| Professional | | $407.38 | $3,548.13 | $4,786.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $323.59 / $6,456.54 / $7,585.78
| Facility | | $323.59 | $6,456.54 | $7,585.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $416.87 / $1,318.26 / $7,943.28
| Professional | | $416.87 | $1,318.26 | $7,943.28 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,456.54 / $13,489.63 / $23,442.29
| Facility | | $6,456.54 | $13,489.63 | $23,442.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,951.21 / $3,162.28 / $4,677.35
| Professional | | $2,951.21 | $3,162.28 | $4,677.35 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $4,365.16
| Professional | | $32.36 | $33.11 | $4,365.16 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,025.60 / $13,182.57 / $23,442.29
| Facility | | $6,025.60 | $13,182.57 | $23,442.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $436.52 / $3,388.44 / $8,128.31
| Professional | | $436.52 | $3,388.44 | $8,128.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $316.23 / $2,511.89 / $4,466.84
| Professional | | $316.23 | $2,511.89 | $4,466.84 |