- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,311.31 / $10,471.29 / $25,703.96
| Facility | | $3,311.31 | $10,471.29 | $25,703.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,148.15 / $1,445.44 / $6,025.60
| Professional | | $1,148.15 | $1,445.44 | $6,025.60 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,165.95 / $12,302.69 / $19,498.45
| Facility | | $6,165.95 | $12,302.69 | $19,498.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,258.93 / $1,621.81 / $3,090.30
| Professional | | $1,258.93 | $1,621.81 | $3,090.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $83.18 / $6,606.93 / $13,182.57
| Facility | | $83.18 | $6,606.93 | $13,182.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,148.15 / $1,659.59 / $3,235.94
| Professional | | $1,148.15 | $1,659.59 | $3,235.94 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $660.69 / $10,715.19 / $34,673.69
| Facility | | $660.69 | $10,715.19 | $34,673.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,071.52 / $1,548.82 / $3,019.95
| Professional | | $1,071.52 | $1,548.82 | $3,019.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $933.25 / $1,318.26 / $1,778.28
| Professional | | $933.25 | $1,318.26 | $1,778.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,096.48 / $1,318.26 / $2,884.03
| Professional | | $1,096.48 | $1,318.26 | $2,884.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,466.84 / $4,466.84 / $7,943.28
| Facility | | $4,466.84 | $4,466.84 | $7,943.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10,232.93 / $10,964.78 / $10,964.78
| Professional | | $10,232.93 | $10,964.78 | $10,964.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $1,862.09
| Professional | | $32.36 | $33.11 | $1,862.09 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,174.90 / $1,584.89 / $2,570.40
| Facility | | $1,174.90 | $1,584.89 | $2,570.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,047.13 / $1,548.82 / $3,235.94
| Professional | | $1,047.13 | $1,548.82 | $3,235.94 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $29,512.09 / $29,512.09 / $29,512.09
| Facility | | $29,512.09 | $29,512.09 | $29,512.09 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4,073.80 / $4,073.80 / $4,073.80
| Professional | | $4,073.80 | $4,073.80 | $4,073.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,071.52 / $1,380.38 / $1,995.26
| Professional | | $1,071.52 | $1,380.38 | $1,995.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,365.16 / $10,000.00 / $22,387.21
| Facility | | $4,365.16 | $10,000.00 | $22,387.21 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,023.29 / $1,380.38 / $2,754.23
| Professional | | $1,023.29 | $1,380.38 | $2,754.23 |