- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,000.00 / $3,715.35 / $12,882.50
| Facility | | $1,000.00 | $3,715.35 | $12,882.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,479.11 / $1,698.24 / $2,630.27
| Professional | | $1,479.11 | $1,698.24 | $2,630.27 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,659.59 / $2,818.38 / $9,120.11
| Facility | | $1,659.59 | $2,818.38 | $9,120.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,412.54 / $1,778.28 / $2,454.71
| Professional | | $1,412.54 | $1,778.28 | $2,454.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,479.11 / $1,479.11 / $1,584.89
| Facility | | $1,479.11 | $1,479.11 | $1,584.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $537.03 / $891.25 / $2,754.23
| Facility | | $537.03 | $891.25 | $2,754.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,230.27 / $2,041.74 / $3,311.31
| Professional | | $1,230.27 | $2,041.74 | $3,311.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $54.95 / $56.23 / $10,000.00
| Facility | | $54.95 | $56.23 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12,589.25 / $13,803.84 / $13,803.84
| Professional | | $12,589.25 | $13,803.84 | $13,803.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,513.56 / $2,041.74 / $3,715.35
| Facility | | $1,513.56 | $2,041.74 | $3,715.35 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,513.56 / $1,778.28 / $2,951.21
| Professional | | $1,513.56 | $1,778.28 | $2,951.21 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $1,348.96
| Professional | | $32.36 | $33.11 | $1,348.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $3,090.30 / $5,370.32
| Professional | | $7.08 | $3,090.30 | $5,370.32 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,513.56 / $1,995.26 / $3,548.13
| Facility | | $1,513.56 | $1,995.26 | $3,548.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $776.25 / $2,041.74 / $3,630.78
| Professional | | $776.25 | $2,041.74 | $3,630.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $446.68 / $2,290.87 / $8,912.51
| Facility | | $446.68 | $2,290.87 | $8,912.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,288.25 / $1,737.80 / $2,691.53
| Professional | | $1,288.25 | $1,737.80 | $2,691.53 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,230.27 / $1,584.89 / $1,819.70
| Professional | | $1,230.27 | $1,584.89 | $1,819.70 |