- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,511.89 / $5,623.41 / $14,454.40
| Facility | | $2,511.89 | $5,623.41 | $14,454.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,511.89 / $3,019.95 / $8,511.38
| Professional | | $2,511.89 | $3,019.95 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11,748.98 / $16,218.10 / $27,542.29
| Facility | | $11,748.98 | $16,218.10 | $27,542.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,691.53 / $5,248.07 / $13,182.57
| Professional | | $2,691.53 | $5,248.07 | $13,182.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7,079.46 / $8,128.31 / $13,182.57
| Facility | | $7,079.46 | $8,128.31 | $13,182.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,630.78 / $10,715.19 / $12,302.69
| Professional | | $3,630.78 | $10,715.19 | $12,302.69 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,570.40 / $5,495.41 / $10,471.29
| Facility | | $2,570.40 | $5,495.41 | $10,471.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4,897.79 / $6,456.54 / $8,317.64
| Professional | | $4,897.79 | $6,456.54 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,511.89 / $3,715.35 / $7,762.47
| Facility | | $2,511.89 | $3,715.35 | $7,762.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,019.95 / $5,011.87 / $20,892.96
| Professional | | $3,019.95 | $5,011.87 | $20,892.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $70.79
| Professional | | $32.36 | $33.11 | $70.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,981.07 / $3,981.07 / $5,623.41
| Facility | | $3,981.07 | $3,981.07 | $5,623.41 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,388.44 / $6,309.57 / $11,481.54
| Professional | | $3,388.44 | $6,309.57 | $11,481.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4,466.84 / $6,760.83 / $10,000.00
| Professional | | $4,466.84 | $6,760.83 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7,079.46 / $46,773.51 / $46,773.51
| Facility | | $7,079.46 | $46,773.51 | $46,773.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5,128.61 / $13,182.57 / $20,892.96
| Professional | | $5,128.61 | $13,182.57 | $20,892.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9,549.93 / $9,549.93 / $9,549.93
| Professional | | $9,549.93 | $9,549.93 | $9,549.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8,709.64 / $15,848.93 / $17,378.01
| Professional | | $8,709.64 | $15,848.93 | $17,378.01 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,290.87 / $7,079.46 / $19,498.45
| Facility | | $2,290.87 | $7,079.46 | $19,498.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,818.38 / $4,265.80 / $11,220.18
| Professional | | $2,818.38 | $4,265.80 | $11,220.18 |