- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,412.54 / $6,025.60 / $18,620.87
| Facility | | $1,412.54 | $6,025.60 | $18,620.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $660.69 / $933.25 / $1,949.84
| Professional | | $660.69 | $933.25 | $1,949.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11,220.18 / $17,782.79 / $36,307.81
| Facility | | $11,220.18 | $17,782.79 | $36,307.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,023.29 / $1,445.44 / $2,041.74
| Professional | | $1,023.29 | $1,445.44 | $2,041.74 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $630.96 / $758.58 / $8,709.64
| Facility | | $630.96 | $758.58 | $8,709.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $707.95 / $1,230.27 / $2,238.72
| Professional | | $707.95 | $1,230.27 | $2,238.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $794.33 / $1,513.56 / $5,888.44
| Facility | | $794.33 | $1,513.56 | $5,888.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $758.58 / $1,479.11 / $3,890.45
| Professional | | $758.58 | $1,479.11 | $3,890.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $338.84
| Professional | | $32.36 | $33.11 | $338.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $870.96 / $1,445.44 / $1,479.11
| Facility | | $870.96 | $1,445.44 | $1,479.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,000.00 / $1,023.29 / $1,819.70
| Facility | | $1,000.00 | $1,023.29 | $1,819.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,023.29 / $1,513.56 / $1,949.84
| Professional | | $1,023.29 | $1,513.56 | $1,949.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12,302.69 / $18,620.87 / $36,307.81
| Facility | | $12,302.69 | $18,620.87 | $36,307.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,023.29 / $1,445.44 / $1,995.26
| Professional | | $1,023.29 | $1,445.44 | $1,995.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,162.28 / $10,715.19 / $19,498.45
| Facility | | $3,162.28 | $10,715.19 | $19,498.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $758.58 / $1,071.52 / $1,949.84
| Professional | | $758.58 | $1,071.52 | $1,949.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $724.44 / $758.58 / $1,380.38
| Professional | | $724.44 | $758.58 | $1,380.38 |