- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,466.84 / $13,182.57 / $28,183.83
| Facility | | $4,466.84 | $13,182.57 | $28,183.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $660.69 / $812.83 / $1,380.38
| Professional | | $660.69 | $812.83 | $1,380.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $27,542.29 / $33,884.42 / $69,183.10
| Facility | | $27,542.29 | $33,884.42 | $69,183.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,023.29 / $1,445.44 / $1,862.09
| Professional | | $1,023.29 | $1,445.44 | $1,862.09 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15,488.17 / $15,488.17 / $25,703.96
| Facility | | $15,488.17 | $15,488.17 | $25,703.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $338.84 / $1,584.89 / $2,238.72
| Professional | | $338.84 | $1,584.89 | $2,238.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $537.03 / $1,445.44 / $32,359.37
| Facility | | $537.03 | $1,445.44 | $32,359.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $489.78 / $1,288.25 / $16,218.10
| Professional | | $489.78 | $1,288.25 | $16,218.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $50.12 / $50.12 / $50.12
| Professional | | $50.12 | $50.12 | $50.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $371.54 / $616.60 / $645.65
| Facility | | $371.54 | $616.60 | $645.65 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,000.00 / $1,000.00 / $1,023.29
| Facility | | $1,000.00 | $1,000.00 | $1,023.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,023.29 / $1,584.89 / $1,949.84
| Professional | | $1,023.29 | $1,584.89 | $1,949.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $26,302.68 / $35,481.34 / $69,183.10
| Facility | | $26,302.68 | $35,481.34 | $69,183.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,023.29 / $1,445.44 / $1,995.26
| Professional | | $1,023.29 | $1,445.44 | $1,995.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9,120.11 / $40,738.03 / $75,857.76
| Facility | | $9,120.11 | $40,738.03 | $75,857.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $794.33 / $1,202.26 / $2,089.30
| Professional | | $794.33 | $1,202.26 | $2,089.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $275.42 / $524.81 / $954.99
| Professional | | $275.42 | $524.81 | $954.99 |