- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,818.38 / $5,248.07 / $14,454.40
| Facility | | $2,818.38 | $5,248.07 | $14,454.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,398.83 / $2,818.38 / $5,248.07
| Professional | | $2,398.83 | $2,818.38 | $5,248.07 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,606.93 / $10,964.78 / $19,054.61
| Facility | | $6,606.93 | $10,964.78 | $19,054.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,511.89 / $4,786.30 / $12,589.25
| Professional | | $2,511.89 | $4,786.30 | $12,589.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,606.93 / $7,762.47 / $12,302.69
| Facility | | $6,606.93 | $7,762.47 | $12,302.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,754.23 / $6,309.57 / $10,715.19
| Professional | | $2,754.23 | $6,309.57 | $10,715.19 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,630.27 / $3,630.78 / $8,912.51
| Facility | | $2,630.27 | $3,630.78 | $8,912.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4,466.84 / $5,623.41 / $8,912.51
| Professional | | $4,466.84 | $5,623.41 | $8,912.51 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,398.83 / $3,388.44 / $7,079.46
| Facility | | $2,398.83 | $3,388.44 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,691.53 / $4,570.88 / $19,498.45
| Professional | | $2,691.53 | $4,570.88 | $19,498.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $70.79
| Professional | | $32.36 | $33.11 | $70.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,801.89 / $3,801.89 / $4,897.79
| Facility | | $3,801.89 | $3,801.89 | $4,897.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,818.38 / $5,248.07 / $9,549.93
| Professional | | $2,818.38 | $5,248.07 | $9,549.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,235.94 / $5,888.44 / $9,120.11
| Professional | | $3,235.94 | $5,888.44 | $9,120.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,570.88 / $48,977.88 / $48,977.88
| Facility | | $4,570.88 | $48,977.88 | $48,977.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,630.27 / $12,589.25 / $19,054.61
| Professional | | $2,630.27 | $12,589.25 | $19,054.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9,332.54 / $9,332.54 / $9,332.54
| Professional | | $9,332.54 | $9,332.54 | $9,332.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7,943.28 / $9,549.93 / $12,882.50
| Professional | | $7,943.28 | $9,549.93 | $12,882.50 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,290.87 / $6,760.83 / $19,498.45
| Facility | | $2,290.87 | $6,760.83 | $19,498.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,511.89 / $3,801.89 / $10,000.00
| Professional | | $2,511.89 | $3,801.89 | $10,000.00 |