- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,466.84 / $10,232.93 / $23,988.33
| Facility | | $4,466.84 | $10,232.93 | $23,988.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,096.48 / $1,380.38 / $6,025.60
| Professional | | $1,096.48 | $1,380.38 | $6,025.60 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8,511.38 / $13,803.84 / $22,908.68
| Facility | | $8,511.38 | $13,803.84 | $22,908.68 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,513.56 / $2,041.74 / $4,073.80
| Professional | | $1,513.56 | $2,041.74 | $4,073.80 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $83.18 / $3,981.07 / $7,079.46
| Facility | | $83.18 | $3,981.07 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,288.25 / $1,949.84 / $4,073.80
| Professional | | $1,288.25 | $1,949.84 | $4,073.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,202.26 / $1,548.82 / $3,467.37
| Professional | | $1,202.26 | $1,548.82 | $3,467.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $977.24 / $1,202.26 / $1,479.11
| Professional | | $977.24 | $1,202.26 | $1,479.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,000.00 / $1,348.96 / $2,454.71
| Professional | | $1,000.00 | $1,348.96 | $2,454.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $54.95 / $56.23 / $7,762.47
| Facility | | $54.95 | $56.23 | $7,762.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8,912.51 / $10,471.29 / $10,471.29
| Professional | | $8,912.51 | $10,471.29 | $10,471.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,819.70 / $1,819.70 / $1,819.70
| Professional | | $1,819.70 | $1,819.70 | $1,819.70 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,230.27 / $1,584.89 / $2,691.53
| Facility | | $1,230.27 | $1,584.89 | $2,691.53 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,174.90 / $1,513.56 / $3,311.31
| Professional | | $1,174.90 | $1,513.56 | $3,311.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4,073.80 / $4,073.80 / $4,073.80
| Professional | | $4,073.80 | $4,073.80 | $4,073.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $954.99 / $1,258.93 / $1,659.59
| Professional | | $954.99 | $1,258.93 | $1,659.59 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,949.84 / $6,165.95 / $18,620.87
| Facility | | $1,949.84 | $6,165.95 | $18,620.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,023.29 / $1,412.54 / $3,630.78
| Professional | | $1,023.29 | $1,412.54 | $3,630.78 |