- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $363.08 / $1,905.46 / $13,803.84
| Facility | | $363.08 | $1,905.46 | $13,803.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $363.08 / $933.25 / $3,715.35
| Professional | | $363.08 | $933.25 | $3,715.35 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12,022.64 / $16,982.44 / $29,512.09
| Facility | | $12,022.64 | $16,982.44 | $29,512.09 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $489.78 / $891.25 / $2,137.96
| Professional | | $489.78 | $891.25 | $2,137.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10,471.29 / $12,302.69 / $19,498.45
| Facility | | $10,471.29 | $12,302.69 | $19,498.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $436.52 / $1,905.46 / $17,378.01
| Professional | | $436.52 | $1,905.46 | $17,378.01 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $218.78 / $2,344.23 / $5,370.32
| Facility | | $218.78 | $2,344.23 | $5,370.32 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $758.58 / $1,230.27 / $10,000.00
| Professional | | $758.58 | $1,230.27 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $218.78 / $2,398.83 / $14,125.38
| Facility | | $218.78 | $2,398.83 | $14,125.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $251.19 / $3,019.95 / $28,183.83
| Professional | | $251.19 | $3,019.95 | $28,183.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $218.78
| Professional | | $32.36 | $33.11 | $218.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $524.81 / $10,715.19 / $17,378.01
| Facility | | $524.81 | $10,715.19 | $17,378.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $416.87 / $1,548.82 / $9,332.54
| Professional | | $416.87 | $1,548.82 | $9,332.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $870.96 / $4,897.79 / $15,848.93
| Professional | | $870.96 | $4,897.79 | $15,848.93 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $18,620.87 / $34,673.69 / $51,286.14
| Facility | | $18,620.87 | $34,673.69 | $51,286.14 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $794.33 / $15,488.17 / $26,302.68
| Professional | | $794.33 | $15,488.17 | $26,302.68 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,318.26 / $1,318.26 / $9,120.11
| Professional | | $1,318.26 | $1,318.26 | $9,120.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $616.60 / $2,454.71 / $22,387.21
| Professional | | $616.60 | $2,454.71 | $22,387.21 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8,912.51 / $14,125.38 / $18,197.01
| Facility | | $8,912.51 | $14,125.38 | $18,197.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $204.17 / $691.83 / $6,918.31
| Professional | | $204.17 | $691.83 | $6,918.31 |