- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,000.00 / $3,715.35 / $12,302.69
| Facility | | $1,000.00 | $3,715.35 | $12,302.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,584.89 / $1,949.84 / $2,951.21
| Professional | | $1,584.89 | $1,949.84 | $2,951.21 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,698.24 / $2,041.74 / $2,884.03
| Professional | | $1,698.24 | $2,041.74 | $2,884.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,778.28 / $1,778.28 / $1,778.28
| Facility | | $1,778.28 | $1,778.28 | $1,778.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,862.09 / $2,454.71 / $3,801.89
| Professional | | $1,862.09 | $2,454.71 | $3,801.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $54.95 / $56.23 / $11,481.54
| Facility | | $54.95 | $56.23 | $11,481.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15,848.93 / $16,982.44 / $16,982.44
| Professional | | $15,848.93 | $16,982.44 | $16,982.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,621.81 / $2,344.23 / $4,677.35
| Facility | | $1,621.81 | $2,344.23 | $4,677.35 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,698.24 / $2,630.27 / $3,630.78
| Professional | | $1,698.24 | $2,630.27 | $3,630.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $257.04
| Professional | | $32.36 | $33.11 | $257.04 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $3,090.30 / $4,677.35
| Professional | | $10.96 | $3,090.30 | $4,677.35 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,698.24 / $2,238.72 / $4,168.69
| Facility | | $1,698.24 | $2,238.72 | $4,168.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,778.28 / $2,454.71 / $3,801.89
| Professional | | $1,778.28 | $2,454.71 | $3,801.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $446.68 / $2,344.23 / $8,912.51
| Facility | | $446.68 | $2,344.23 | $8,912.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,479.11 / $1,995.26 / $3,235.94
| Professional | | $1,479.11 | $1,995.26 | $3,235.94 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,778.28 / $1,995.26 / $1,995.26
| Professional | | $1,778.28 | $1,995.26 | $1,995.26 |