- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,454.71 / $6,456.54 / $16,218.10
| Facility | | $2,454.71 | $6,456.54 | $16,218.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,454.71 / $5,888.44 / $7,943.28
| Professional | | $2,454.71 | $5,888.44 | $7,943.28 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7,762.47 / $7,762.47 / $33,113.11
| Facility | | $7,762.47 | $7,762.47 | $33,113.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $309.03 / $309.03 / $549.54
| Professional | | $309.03 | $309.03 | $549.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6,025.60 / $6,606.93 / $7,244.36
| Professional | | $6,025.60 | $6,606.93 | $7,244.36 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7,943.28 / $15,135.61 / $39,810.72
| Facility | | $7,943.28 | $15,135.61 | $39,810.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,890.45 / $4,677.35 / $7,943.28
| Professional | | $3,890.45 | $4,677.35 | $7,943.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7,762.47 / $8,511.38 / $10,964.78
| Professional | | $7,762.47 | $8,511.38 | $10,964.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,630.27 / $6,918.31 / $13,182.57
| Facility | | $2,630.27 | $6,918.31 | $13,182.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5,011.87 / $5,011.87 / $16,218.10
| Professional | | $5,011.87 | $5,011.87 | $16,218.10 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,754.40 / $9,120.11 / $15,848.93
| Facility | | $5,754.40 | $9,120.11 | $15,848.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5,495.41 / $10,000.00 / $15,135.61
| Professional | | $5,495.41 | $10,000.00 | $15,135.61 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,677.35 / $7,762.47 / $9,332.54
| Facility | | $4,677.35 | $7,762.47 | $9,332.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,235.94 / $3,890.45 / $8,511.38
| Professional | | $3,235.94 | $3,890.45 | $8,511.38 |