- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $977.24 / $7,943.28 / $20,892.96
| Facility | | $977.24 | $7,943.28 | $20,892.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $501.19 / $676.08 / $1,288.25
| Professional | | $501.19 | $676.08 | $1,288.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,495.41 / $8,317.64 / $17,378.01
| Facility | | $5,495.41 | $8,317.64 | $17,378.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $724.44 / $1,071.52 / $1,348.96
| Professional | | $724.44 | $1,071.52 | $1,348.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,801.89 / $3,801.89 / $3,801.89
| Facility | | $3,801.89 | $3,801.89 | $3,801.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $645.65 / $1,047.13 / $1,548.82
| Professional | | $645.65 | $1,047.13 | $1,548.82 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $831.76 / $1,318.26 / $13,182.57
| Facility | | $831.76 | $1,318.26 | $13,182.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $831.76 / $1,202.26 / $2,344.23
| Professional | | $831.76 | $1,202.26 | $2,344.23 |
- 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
- $831.76 / $1,000.00 / $1,096.48
| Facility | | $831.76 | $1,000.00 | $1,096.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $707.95 / $707.95 / $724.44
| Facility | | $707.95 | $707.95 | $724.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $724.44 / $1,096.48 / $1,513.56
| Professional | | $724.44 | $1,096.48 | $1,513.56 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,888.44 / $8,511.38 / $17,378.01
| Facility | | $5,888.44 | $8,511.38 | $17,378.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $724.44 / $1,047.13 / $1,348.96
| Professional | | $724.44 | $1,047.13 | $1,348.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,137.96 / $9,772.37 / $18,197.01
| Facility | | $2,137.96 | $9,772.37 | $18,197.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $562.34 / $831.76 / $1,380.38
| Professional | | $562.34 | $831.76 | $1,380.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $549.54 / $645.65 / $977.24
| Professional | | $549.54 | $645.65 | $977.24 |