- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $776.25 / $10,232.93 / $30,199.52
| Facility | | $776.25 | $10,232.93 | $30,199.52 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $446.68 / $3,801.89 / $18,620.87
| Professional | | $446.68 | $3,801.89 | $18,620.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $354.81 / $354.81 / $354.81
| Professional | | $354.81 | $354.81 | $354.81 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $23,442.29 / $29,512.09 / $60,255.96
| Facility | | $23,442.29 | $29,512.09 | $60,255.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $575.44 / $1,288.25 / $10,964.78
| Professional | | $575.44 | $1,288.25 | $10,964.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15,135.61 / $15,135.61 / $15,135.61
| Facility | | $15,135.61 | $15,135.61 | $15,135.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $588.84 / $1,288.25 / $13,489.63
| Professional | | $588.84 | $1,288.25 | $13,489.63 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $741.31 / $8,128.31 / $46,773.51
| Facility | | $741.31 | $8,128.31 | $46,773.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $758.58 / $5,754.40 / $13,803.84
| Professional | | $758.58 | $5,754.40 | $13,803.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $32.36 / $33.11
| Professional | | $32.36 | $32.36 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,623.41 / $8,511.38 / $9,332.54
| Facility | | $5,623.41 | $8,511.38 | $9,332.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,165.95 / $6,606.93 / $6,606.93
| Facility | | $6,165.95 | $6,606.93 | $6,606.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $562.34 / $6,165.95 / $11,220.18
| Professional | | $562.34 | $6,165.95 | $11,220.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $21,877.62 / $30,199.52 / $60,255.96
| Facility | | $21,877.62 | $30,199.52 | $60,255.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $691.83 / $1,288.25 / $10,471.29
| Professional | | $691.83 | $1,288.25 | $10,471.29 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10,964.78 / $36,307.81 / $66,069.34
| Facility | | $10,964.78 | $36,307.81 | $66,069.34 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $602.56 / $4,365.16 / $10,232.93
| Professional | | $602.56 | $4,365.16 | $10,232.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $426.58 / $741.31 / $10,000.00
| Professional | | $426.58 | $741.31 | $10,000.00 |