- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,548.13 / $10,000.00 / $22,908.68
| Facility | | $3,548.13 | $10,000.00 | $22,908.68 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $371.54 / $489.78 / $2,344.23
| Professional | | $371.54 | $489.78 | $2,344.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,128.61 / $12,882.50 / $22,387.21
| Facility | | $5,128.61 | $12,882.50 | $22,387.21 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $562.34 / $776.25 / $1,548.82
| Professional | | $562.34 | $776.25 | $1,548.82 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $79.43 / $3,801.89 / $7,079.46
| Facility | | $79.43 | $3,801.89 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $426.58 / $660.69 / $1,318.26
| Professional | | $426.58 | $660.69 | $1,318.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $436.52 / $562.34 / $1,258.93
| Professional | | $436.52 | $562.34 | $1,258.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $302.00 / $426.58 / $537.03
| Professional | | $302.00 | $426.58 | $537.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $380.19 / $501.19 / $1,023.29
| Professional | | $380.19 | $501.19 | $1,023.29 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $54.95 / $56.23 / $2,818.38
| Facility | | $54.95 | $56.23 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,548.13 / $4,168.69 / $4,168.69
| Professional | | $3,548.13 | $4,168.69 | $4,168.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $691.83 / $691.83 / $691.83
| Professional | | $691.83 | $691.83 | $691.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $467.74 / $575.44 / $954.99
| Facility | | $467.74 | $575.44 | $954.99 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $426.58 / $549.54 / $1,174.90
| Professional | | $426.58 | $549.54 | $1,174.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,445.44 / $1,445.44 / $1,445.44
| Professional | | $1,445.44 | $1,445.44 | $1,445.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $346.74 / $457.09 / $645.65
| Professional | | $346.74 | $457.09 | $645.65 |
- 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
- $371.54 / $524.81 / $1,348.96
| Professional | | $371.54 | $524.81 | $1,348.96 |