- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $977.24 / $1,995.26 / $14,454.40
| Facility | | $977.24 | $1,995.26 | $14,454.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $912.01 / $1,000.00 / $2,398.83
| Professional | | $912.01 | $1,000.00 | $2,398.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9,120.11 / $12,882.50 / $20,892.96
| Facility | | $9,120.11 | $12,882.50 | $20,892.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $954.99 / $1,862.09 / $4,677.35
| Professional | | $954.99 | $1,862.09 | $4,677.35 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,454.71 / $2,884.03 / $4,677.35
| Facility | | $2,454.71 | $2,884.03 | $4,677.35 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,071.52 / $3,090.30 / $3,467.37
| Professional | | $1,071.52 | $3,090.30 | $3,467.37 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $977.24 / $7,413.10 / $13,489.63
| Facility | | $977.24 | $7,413.10 | $13,489.63 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,698.24 / $2,398.83 / $2,951.21
| Professional | | $1,698.24 | $2,398.83 | $2,951.21 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,122.02 / $10,232.93 / $16,595.87
| Facility | | $1,122.02 | $10,232.93 | $16,595.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $977.24 / $1,737.80 / $6,606.93
| Professional | | $977.24 | $1,737.80 | $6,606.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $1,288.25
| Professional | | $32.36 | $33.11 | $1,288.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,905.46 / $10,715.19 / $17,378.01
| Facility | | $1,905.46 | $10,715.19 | $17,378.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,318.26 / $2,398.83 / $3,162.28
| Professional | | $1,318.26 | $2,398.83 | $3,162.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,122.02 / $2,187.76 / $4,073.80
| Professional | | $1,122.02 | $2,187.76 | $4,073.80 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8,912.51 / $13,489.63 / $13,489.63
| Facility | | $8,912.51 | $13,489.63 | $13,489.63 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,318.26 / $4,786.30 / $15,488.17
| Professional | | $1,318.26 | $4,786.30 | $15,488.17 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4,897.79 / $4,897.79 / $4,897.79
| Professional | | $4,897.79 | $4,897.79 | $4,897.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4,466.84 / $5,623.41 / $7,079.46
| Professional | | $4,466.84 | $5,623.41 | $7,079.46 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8,912.51 / $14,125.38 / $17,378.01
| Facility | | $8,912.51 | $14,125.38 | $17,378.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $933.25 / $1,659.59 / $4,168.69
| Professional | | $933.25 | $1,659.59 | $4,168.69 |