- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,677.35 / $7,413.10 / $20,892.96
| Facility | | $4,677.35 | $7,413.10 | $20,892.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,570.40 / $3,630.78 / $7,585.78
| Professional | | $2,570.40 | $3,630.78 | $7,585.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4,677.35 / $6,456.54 / $8,511.38
| Professional | | $4,677.35 | $6,456.54 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $501.19 / $870.96 / $5,754.40
| Facility | | $501.19 | $870.96 | $5,754.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,290.87 / $4,897.79 / $10,000.00
| Professional | | $2,290.87 | $4,897.79 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,162.28 / $5,248.07 / $8,317.64
| Facility | | $3,162.28 | $5,248.07 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,090.30 / $5,128.61 / $8,317.64
| Professional | | $3,090.30 | $5,128.61 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $1,479.11
| Professional | | $32.36 | $33.11 | $1,479.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,801.89 / $6,025.60 / $6,760.83
| Facility | | $3,801.89 | $6,025.60 | $6,760.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,677.35 / $4,677.35 / $4,677.35
| Facility | | $4,677.35 | $4,677.35 | $4,677.35 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4,677.35 / $6,760.83 / $9,549.93
| Professional | | $4,677.35 | $6,760.83 | $9,549.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4,897.79 / $6,606.93 / $8,511.38
| Professional | | $4,897.79 | $6,606.93 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $691.83 / $1,258.93 / $3,715.35
| Facility | | $691.83 | $1,258.93 | $3,715.35 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,162.28 / $4,466.84 / $8,912.51
| Professional | | $3,162.28 | $4,466.84 | $8,912.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,162.28 / $3,630.78 / $6,309.57
| Professional | | $3,162.28 | $3,630.78 | $6,309.57 |