- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,071.52 / $2,041.74 / $14,454.40
| Facility | | $1,071.52 | $2,041.74 | $14,454.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $912.01 / $1,071.52 / $2,511.89
| Professional | | $912.01 | $1,071.52 | $2,511.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,606.93 / $11,220.18 / $19,054.61
| Facility | | $6,606.93 | $11,220.18 | $19,054.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $933.25 / $1,905.46 / $4,466.84
| Professional | | $933.25 | $1,905.46 | $4,466.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,570.40 / $3,019.95 / $4,786.30
| Facility | | $2,570.40 | $3,019.95 | $4,786.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,122.02 / $2,818.38 / $3,388.44
| Professional | | $1,122.02 | $2,818.38 | $3,388.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,071.52 / $7,244.36 / $13,489.63
| Facility | | $1,071.52 | $7,244.36 | $13,489.63 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,778.28 / $2,454.71 / $3,019.95
| Professional | | $1,778.28 | $2,454.71 | $3,019.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,148.15 / $8,709.64 / $16,595.87
| Facility | | $1,148.15 | $8,709.64 | $16,595.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $977.24 / $1,659.59 / $4,677.35
| Professional | | $977.24 | $1,659.59 | $4,677.35 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $1,230.27
| Professional | | $32.36 | $33.11 | $1,230.27 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,862.09 / $10,715.19 / $17,378.01
| Facility | | $1,862.09 | $10,715.19 | $17,378.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,318.26 / $2,454.71 / $2,884.03
| Professional | | $1,318.26 | $2,454.71 | $2,884.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,230.27 / $2,398.83 / $3,311.31
| Professional | | $1,230.27 | $2,398.83 | $3,311.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,570.40 / $9,120.11 / $9,120.11
| Facility | | $2,570.40 | $9,120.11 | $9,120.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,479.11 / $4,677.35 / $10,000.00
| Professional | | $1,479.11 | $4,677.35 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,454.71 / $2,454.71 / $2,454.71
| Professional | | $2,454.71 | $2,454.71 | $2,454.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,238.72 / $5,248.07 / $5,370.32
| Professional | | $2,238.72 | $5,248.07 | $5,370.32 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,165.95 / $13,803.84 / $16,595.87
| Facility | | $6,165.95 | $13,803.84 | $16,595.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $933.25 / $1,584.89 / $4,073.80
| Professional | | $933.25 | $1,584.89 | $4,073.80 |