- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,174.90 / $2,187.76 / $14,454.40
| Facility | | $1,174.90 | $2,187.76 | $14,454.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,000.00 / $1,174.90 / $2,691.53
| Professional | | $1,000.00 | $1,174.90 | $2,691.53 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,606.93 / $11,220.18 / $18,197.01
| Facility | | $6,606.93 | $11,220.18 | $18,197.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,023.29 / $2,089.30 / $4,897.79
| Professional | | $1,023.29 | $2,089.30 | $4,897.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,818.38 / $3,311.31 / $5,248.07
| Facility | | $2,818.38 | $3,311.31 | $5,248.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,202.26 / $3,090.30 / $3,715.35
| Professional | | $1,202.26 | $3,090.30 | $3,715.35 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,174.90 / $7,244.36 / $13,489.63
| Facility | | $1,174.90 | $7,244.36 | $13,489.63 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,905.46 / $2,630.27 / $3,311.31
| Professional | | $1,905.46 | $2,630.27 | $3,311.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,174.90 / $2,818.38 / $9,549.93
| Facility | | $1,174.90 | $2,818.38 | $9,549.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,047.13 / $1,778.28 / $5,128.61
| Professional | | $1,047.13 | $1,778.28 | $5,128.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $1,380.38
| Professional | | $32.36 | $33.11 | $1,380.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,584.89 / $1,584.89 / $2,089.30
| Facility | | $1,584.89 | $1,584.89 | $2,089.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,479.11 / $2,691.53 / $3,235.94
| Professional | | $1,479.11 | $2,691.53 | $3,235.94 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,288.25 / $2,511.89 / $3,467.37
| Professional | | $1,288.25 | $2,511.89 | $3,467.37 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,754.23 / $8,709.64 / $8,709.64
| Facility | | $2,754.23 | $8,709.64 | $8,709.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,621.81 / $5,128.61 / $7,762.47
| Professional | | $1,621.81 | $5,128.61 | $7,762.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,691.53 / $2,691.53 / $2,691.53
| Professional | | $2,691.53 | $2,691.53 | $2,691.53 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,398.83 / $5,754.40 / $5,888.44
| Professional | | $2,398.83 | $5,754.40 | $5,888.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,290.87 / $7,079.46 / $19,498.45
| Facility | | $2,290.87 | $7,079.46 | $19,498.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,000.00 / $1,698.24 / $4,466.84
| Professional | | $1,000.00 | $1,698.24 | $4,466.84 |