- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,412.54 / $12,589.25 / $26,302.68
| Facility | | $1,412.54 | $12,589.25 | $26,302.68 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $758.58 / $1,071.52 / $3,019.95
| Professional | | $758.58 | $1,071.52 | $3,019.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11,220.18 / $15,488.17 / $31,622.78
| Facility | | $11,220.18 | $15,488.17 | $31,622.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,023.29 / $1,445.44 / $1,905.46
| Professional | | $1,023.29 | $1,445.44 | $1,905.46 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,073.80 / $4,073.80 / $6,760.83
| Facility | | $4,073.80 | $4,073.80 | $6,760.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $912.01 / $1,412.54 / $2,238.72
| Professional | | $912.01 | $1,412.54 | $2,238.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,071.52 / $1,819.70 / $15,848.93
| Facility | | $1,071.52 | $1,819.70 | $15,848.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,000.00 / $1,659.59 / $5,495.41
| Professional | | $1,000.00 | $1,659.59 | $5,495.41 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $64.57
| Professional | | $32.36 | $33.11 | $64.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $776.25 / $1,479.11 / $1,513.56
| Facility | | $776.25 | $1,479.11 | $1,513.56 |
- 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 / $2,187.76
| Professional | | $1,023.29 | $1,584.89 | $2,187.76 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11,748.98 / $15,848.93 / $31,622.78
| Facility | | $11,748.98 | $15,848.93 | $31,622.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,023.29 / $1,479.11 / $2,041.74
| Professional | | $1,023.29 | $1,479.11 | $2,041.74 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,370.32 / $19,054.61 / $34,673.69
| Facility | | $5,370.32 | $19,054.61 | $34,673.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $812.83 / $1,174.90 / $2,089.30
| Professional | | $812.83 | $1,174.90 | $2,089.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $724.44 / $912.01 / $1,380.38
| Professional | | $724.44 | $912.01 | $1,380.38 |