- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,090.30 / $5,888.44 / $14,454.40
| Facility | | $3,090.30 | $5,888.44 | $14,454.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,630.27 / $3,090.30 / $5,888.44
| Professional | | $2,630.27 | $3,090.30 | $5,888.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,011.87 / $8,317.64 / $13,803.84
| Facility | | $5,011.87 | $8,317.64 | $13,803.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,818.38 / $5,370.32 / $14,125.38
| Professional | | $2,818.38 | $5,370.32 | $14,125.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7,413.10 / $8,511.38 / $13,803.84
| Facility | | $7,413.10 | $8,511.38 | $13,803.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,019.95 / $7,079.46 / $12,022.64
| Professional | | $3,019.95 | $7,079.46 | $12,022.64 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,398.83 / $3,630.78 / $8,912.51
| Facility | | $2,398.83 | $3,630.78 | $8,912.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5,011.87 / $6,165.95 / $10,000.00
| Professional | | $5,011.87 | $6,165.95 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,187.76 / $3,388.44 / $7,762.47
| Facility | | $2,187.76 | $3,388.44 | $7,762.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,570.40 / $5,128.61 / $21,877.62
| Professional | | $2,570.40 | $5,128.61 | $21,877.62 |
- 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
- $4,265.80 / $4,265.80 / $5,888.44
| Facility | | $4,265.80 | $4,265.80 | $5,888.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,162.28 / $5,888.44 / $10,715.19
| Professional | | $3,162.28 | $5,888.44 | $10,715.19 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,630.78 / $6,606.93 / $10,232.93
| Professional | | $3,630.78 | $6,606.93 | $10,232.93 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,128.61 / $26,915.35 / $26,915.35
| Facility | | $5,128.61 | $26,915.35 | $26,915.35 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,884.03 / $14,125.38 / $21,379.62
| Professional | | $2,884.03 | $14,125.38 | $21,379.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10,471.29 / $10,471.29 / $10,471.29
| Professional | | $10,471.29 | $10,471.29 | $10,471.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8,912.51 / $11,220.18 / $14,454.40
| Professional | | $8,912.51 | $11,220.18 | $14,454.40 |
- 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 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,570.40 / $4,265.80 / $11,220.18
| Professional | | $2,570.40 | $4,265.80 | $11,220.18 |