- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,096.48 / $3,715.35 / $12,022.64
| Facility | | $1,096.48 | $3,715.35 | $12,022.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $776.25 / $1,023.29 / $1,737.80
| Professional | | $776.25 | $1,023.29 | $1,737.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $741.31 / $776.25 / $870.96
| Professional | | $741.31 | $776.25 | $870.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,235.94 / $6,025.60 / $11,481.54
| Facility | | $3,235.94 | $6,025.60 | $11,481.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $309.03 / $954.99 / $1,348.96
| Professional | | $309.03 | $954.99 | $1,348.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $776.25 / $1,000.00 / $5,011.87
| Facility | | $776.25 | $1,000.00 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $870.96 / $1,202.26 / $1,513.56
| Professional | | $870.96 | $1,202.26 | $1,513.56 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $741.31 / $3,467.37 / $3,467.37
| Facility | | $741.31 | $3,467.37 | $3,467.37 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,570.40 / $2,570.40 / $2,691.53
| Facility | | $2,570.40 | $2,570.40 | $2,691.53 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $870.96 / $1,148.15 / $1,905.46
| Professional | | $870.96 | $1,148.15 | $1,905.46 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12,302.69 / $33,884.42 / $33,884.42
| Facility | | $12,302.69 | $33,884.42 | $33,884.42 |
- Facility/Professional
- Facility
- Modifier
- AS
- Typical Low / Median / Typical High
- $1,230.27 / $1,230.27 / $1,230.27
| Facility | AS | $1,230.27 | $1,230.27 | $1,230.27 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7,943.28 / $7,943.28 / $7,943.28
| Professional | | $7,943.28 | $7,943.28 | $7,943.28 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $851.14 / $1,380.38 / $5,370.32
| Facility | | $851.14 | $1,380.38 | $5,370.32 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $831.76 / $1,122.02 / $1,995.26
| Professional | | $831.76 | $1,122.02 | $1,995.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $120.23 / $1,995.26
| Professional | | $32.36 | $120.23 | $1,995.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,071.52 / $1,071.52 / $1,071.52
| Professional | | $1,071.52 | $1,071.52 | $1,071.52 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $812.83 / $1,047.13 / $1,949.84
| Facility | | $812.83 | $1,047.13 | $1,949.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $870.96 / $1,148.15 / $1,905.46
| Professional | | $870.96 | $1,148.15 | $1,905.46 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,187.76 / $6,025.60 / $11,481.54
| Facility | | $2,187.76 | $6,025.60 | $11,481.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $707.95 / $954.99 / $1,479.11
| Professional | | $707.95 | $954.99 | $1,479.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $741.31 / $776.25 / $776.25
| Professional | | $741.31 | $776.25 | $776.25 |