- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,096.48 / $4,265.80 / $14,454.40
| Facility | | $1,096.48 | $4,265.80 | $14,454.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $741.31 / $2,754.23 / $8,128.31
| Professional | | $741.31 | $2,754.23 | $8,128.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7,585.78 / $12,882.50 / $25,703.96
| Facility | | $7,585.78 | $12,882.50 | $25,703.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $724.44 / $4,786.30 / $8,128.31
| Professional | | $724.44 | $4,786.30 | $8,128.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $676.08 / $676.08 / $676.08
| Facility | | $676.08 | $676.08 | $676.08 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10,000.00 / $10,000.00 / $10,000.00
| Facility | | $10,000.00 | $10,000.00 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $851.14 / $2,238.72 / $11,220.18
| Professional | | $851.14 | $2,238.72 | $11,220.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $41,686.94 / $50,118.72 / $50,118.72
| Facility | | $41,686.94 | $50,118.72 | $50,118.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $38,904.51 / $45,708.82 / $45,708.82
| Professional | | $38,904.51 | $45,708.82 | $45,708.82 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $851.14 / $2,570.40 / $10,232.93
| Facility | | $851.14 | $2,570.40 | $10,232.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $776.25 / $4,570.88 / $10,232.93
| Professional | | $776.25 | $4,570.88 | $10,232.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $33.11
| Professional | | $32.36 | $33.11 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $14,454.40 / $16,595.87
| Professional | | $5.01 | $14,454.40 | $16,595.87 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $776.25 / $1,819.70 / $10,232.93
| Facility | | $776.25 | $1,819.70 | $10,232.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $812.83 / $2,290.87 / $11,220.18
| Professional | | $812.83 | $2,290.87 | $11,220.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,677.35 / $9,332.54 / $23,988.33
| Facility | | $4,677.35 | $9,332.54 | $23,988.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $707.95 / $1,584.89 / $8,912.51
| Professional | | $707.95 | $1,584.89 | $8,912.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5,370.32 / $5,623.41 / $5,623.41
| Professional | | $5,370.32 | $5,623.41 | $5,623.41 |