- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,905.46 / $3,548.13 / $14,454.40
| Facility | | $1,905.46 | $3,548.13 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9,120.11 / $12,882.50 / $22,908.68
| Facility | | $9,120.11 | $12,882.50 | $22,908.68 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,466.84 / $5,128.61 / $8,317.64
| Facility | | $4,466.84 | $5,128.61 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- AS
- Typical Low / Median / Typical High
- $302.00 / $302.00 / $302.00
| Facility | AS | $302.00 | $302.00 | $302.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,584.89 / $2,398.83 / $8,912.51
| Facility | | $1,584.89 | $2,398.83 | $8,912.51 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,548.82 / $2,398.83 / $6,309.57
| Facility | | $1,548.82 | $2,398.83 | $6,309.57 |
- Facility/Professional
- Facility
- Modifier
- AS
- Typical Low / Median / Typical High
- $794.33 / $794.33 / $794.33
| Facility | AS | $794.33 | $794.33 | $794.33 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,511.89 / $2,511.89 / $3,548.13
| Facility | | $2,511.89 | $2,511.89 | $3,548.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,137.96 / $3,801.89 / $5,888.44
| Professional | | $2,137.96 | $3,801.89 | $5,888.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,019.95 / $15,848.93 / $15,848.93
| Facility | | $3,019.95 | $15,848.93 | $15,848.93 |
- Facility/Professional
- Facility
- Modifier
- AS
- Typical Low / Median / Typical High
- $302.00 / $446.68 / $1,584.89
| Facility | AS | $302.00 | $446.68 | $1,584.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6,309.57 / $6,309.57 / $6,309.57
| Professional | | $6,309.57 | $6,309.57 | $6,309.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,995.26 / $6,760.83 / $19,498.45
| Facility | | $1,995.26 | $6,760.83 | $19,498.45 |