- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $380.19 / $851.14 / $14,454.40
| Facility | | $380.19 | $851.14 | $14,454.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $380.19 / $446.68 / $1,071.52
| Professional | | $380.19 | $446.68 | $1,071.52 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13,803.84 / $18,620.87 / $30,902.95
| Facility | | $13,803.84 | $18,620.87 | $30,902.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $398.11 / $794.33 / $2,137.96
| Professional | | $398.11 | $794.33 | $2,137.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,096.48 / $1,258.93 / $2,137.96
| Facility | | $1,096.48 | $1,258.93 | $2,137.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $537.03 / $1,659.59 / $1,862.09
| Professional | | $537.03 | $1,659.59 | $1,862.09 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $389.05 / $851.14 / $4,168.69
| Facility | | $389.05 | $851.14 | $4,168.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $741.31 / $1,000.00 / $1,230.27
| Professional | | $741.31 | $1,000.00 | $1,230.27 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $407.38 / $851.14 / $26,302.68
| Facility | | $407.38 | $851.14 | $26,302.68 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $416.87 / $741.31 / $8,511.38
| Professional | | $416.87 | $741.31 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $85.11
| Professional | | $32.36 | $33.11 | $85.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $660.69 / $17,378.01 / $43,651.58
| Facility | | $660.69 | $17,378.01 | $43,651.58 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $380.19 / $776.25 / $1,778.28
| Professional | | $380.19 | $776.25 | $1,778.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $741.31 / $1,122.02 / $1,621.81
| Professional | | $741.31 | $1,122.02 | $1,621.81 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $31,622.78 / $60,255.96 / $89,125.09
| Facility | | $31,622.78 | $60,255.96 | $89,125.09 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $794.33 / $1,949.84 / $8,511.38
| Professional | | $794.33 | $1,949.84 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,412.54 / $1,412.54 / $1,412.54
| Professional | | $1,412.54 | $1,412.54 | $1,412.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,288.25 / $2,344.23 / $2,630.27
| Professional | | $1,288.25 | $2,344.23 | $2,630.27 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10,471.29 / $21,379.62 / $38,018.94
| Facility | | $10,471.29 | $21,379.62 | $38,018.94 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $398.11 / $616.60 / $1,659.59
| Professional | | $398.11 | $616.60 | $1,659.59 |