- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,023.29 / $13,489.63 / $32,359.37
| Facility | | $1,023.29 | $13,489.63 | $32,359.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $562.34 / $7,244.36 / $19,498.45
| Professional | | $562.34 | $7,244.36 | $19,498.45 |
- 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
- $741.31 / $1,659.59 / $19,952.62
| Professional | | $741.31 | $1,659.59 | $19,952.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15,488.17 / $15,488.17 / $15,488.17
| Facility | | $15,488.17 | $15,488.17 | $15,488.17 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $741.31 / $1,698.24 / $25,703.96
| Professional | | $741.31 | $1,698.24 | $25,703.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $977.24 / $10,232.93 / $46,773.51
| Facility | | $977.24 | $10,232.93 | $46,773.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,000.00 / $8,709.64 / $24,547.09
| Professional | | $1,000.00 | $8,709.64 | $24,547.09 |
- 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
- $9,549.93 / $15,848.93 / $18,620.87
| Facility | | $9,549.93 | $15,848.93 | $18,620.87 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11,481.54 / $12,302.69 / $12,302.69
| Facility | | $11,481.54 | $12,302.69 | $12,302.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $741.31 / $11,481.54 / $20,892.96
| Professional | | $741.31 | $11,481.54 | $20,892.96 |
- 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
- $912.01 / $1,659.59 / $19,498.45
| Professional | | $912.01 | $1,659.59 | $19,498.45 |
- 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
- $794.33 / $7,943.28 / $20,417.38
| Professional | | $794.33 | $7,943.28 | $20,417.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $549.54 / $954.99 / $18,620.87
| Professional | | $549.54 | $954.99 | $18,620.87 |