- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,897.79 / $12,302.69 / $35,481.34
| Facility | | $4,897.79 | $12,302.69 | $35,481.34 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $524.81 / $831.76 / $2,818.38
| Professional | | $524.81 | $831.76 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $457.09 / $512.86 / $3,019.95
| Professional | | $457.09 | $512.86 | $3,019.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9,772.37 / $16,982.44 / $28,840.32
| Facility | | $9,772.37 | $16,982.44 | $28,840.32 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $851.14 / $1,174.90 / $2,238.72
| Professional | | $851.14 | $1,174.90 | $2,238.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $83.18 / $9,332.54 / $21,379.62
| Facility | | $83.18 | $9,332.54 | $21,379.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $501.19 / $741.31 / $1,778.28
| Professional | | $501.19 | $741.31 | $1,778.28 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9,549.93 / $14,791.08 / $23,988.33
| Facility | | $9,549.93 | $14,791.08 | $23,988.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $630.96 / $776.25 / $1,778.28
| Professional | | $630.96 | $776.25 | $1,778.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $478.63 / $478.63 / $10,000.00
| Professional | | $478.63 | $478.63 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $407.38 / $537.03 / $1,047.13
| Professional | | $407.38 | $537.03 | $1,047.13 |
- Facility/Professional
- Professional
- Modifier
- 80
- Typical Low / Median / Typical High
- $501.19 / $501.19 / $501.19
| Professional | 80 | $501.19 | $501.19 | $501.19 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $40,738.03 / $40,738.03 / $40,738.03
| Facility | | $40,738.03 | $40,738.03 | $40,738.03 |
- Facility/Professional
- Facility
- Modifier
- 52
- Typical Low / Median / Typical High
- $33,113.11 / $33,113.11 / $33,113.11
| Facility | 52 | $33,113.11 | $33,113.11 | $33,113.11 |
- Facility/Professional
- Facility
- Modifier
- 53
- Typical Low / Median / Typical High
- $8,128.31 / $8,128.31 / $8,128.31
| Facility | 53 | $8,128.31 | $8,128.31 | $8,128.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,548.13 / $4,897.79 / $4,897.79
| Professional | | $3,548.13 | $4,897.79 | $4,897.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $851.14 / $851.14 / $851.14
| Professional | | $851.14 | $851.14 | $851.14 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $537.03 / $831.76 / $19,498.45
| Facility | | $537.03 | $831.76 | $19,498.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $616.60 / $776.25 / $1,659.59
| Professional | | $616.60 | $776.25 | $1,659.59 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,862.09 / $1,862.09 / $1,862.09
| Professional | | $1,862.09 | $1,862.09 | $1,862.09 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $380.19 / $524.81 / $812.83
| Professional | | $380.19 | $524.81 | $812.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7,762.47 / $14,454.40 / $29,512.09
| Facility | | $7,762.47 | $14,454.40 | $29,512.09 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $489.78 / $724.44 / $1,584.89
| Professional | | $489.78 | $724.44 | $1,584.89 |