- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,230.27 / $4,897.79 / $10,964.78
| Facility | | $1,230.27 | $4,897.79 | $10,964.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,041.74 / $2,511.89 / $4,466.84
| Professional | | $2,041.74 | $2,511.89 | $4,466.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,905.46 / $1,905.46 / $1,905.46
| Professional | | $1,905.46 | $1,905.46 | $1,905.46 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,584.89 / $5,495.41 / $12,302.69
| Facility | | $1,584.89 | $5,495.41 | $12,302.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,949.84 / $2,398.83 / $2,818.38
| Professional | | $1,949.84 | $2,398.83 | $2,818.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $398.11 / $457.09 / $7,413.10
| Facility | | $398.11 | $457.09 | $7,413.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,778.28 / $2,951.21 / $5,011.87
| Professional | | $1,778.28 | $2,951.21 | $5,011.87 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10,000.00 / $23,442.29 / $34,673.69
| Facility | | $10,000.00 | $23,442.29 | $34,673.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,202.26 / $1,819.70 / $2,884.03
| Professional | | $1,202.26 | $1,819.70 | $2,884.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $2,951.21
| Professional | | $32.36 | $33.11 | $2,951.21 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $616.60 / $4,365.16 / $9,549.93
| Facility | | $616.60 | $4,365.16 | $9,549.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,737.80 / $2,398.83 / $4,365.16
| Professional | | $1,737.80 | $2,398.83 | $4,365.16 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,778.28 / $1,778.28 / $2,511.89
| Professional | | $1,778.28 | $1,778.28 | $2,511.89 |