- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $41.69 / $4,897.79 / $37,153.52
| Facility | | $41.69 | $4,897.79 | $37,153.52 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $562.34 / $1,288.25 / $3,019.95
| Professional | | $562.34 | $1,288.25 | $3,019.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14,791.08 / $26,915.35 / $42,657.95
| Facility | | $14,791.08 | $26,915.35 | $42,657.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $562.34 / $891.25 / $2,630.27
| Professional | | $562.34 | $891.25 | $2,630.27 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,348.96 / $1,348.96 / $1,348.96
| Professional | | $1,348.96 | $1,348.96 | $1,348.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,412.54 / $1,862.09 / $2,754.23
| Facility | | $1,412.54 | $1,862.09 | $2,754.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $870.96 / $1,584.89 / $1,995.26
| Professional | | $870.96 | $1,584.89 | $1,995.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $602.56 / $7,413.10 / $14,454.40
| Facility | | $602.56 | $7,413.10 | $14,454.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,000.00 / $1,348.96 / $1,584.89
| Professional | | $1,000.00 | $1,348.96 | $1,584.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $660.69 / $15,135.61 / $25,703.96
| Facility | | $660.69 | $15,135.61 | $25,703.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $676.08 / $1,122.02 / $3,090.30
| Professional | | $676.08 | $1,122.02 | $3,090.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $776.25
| Professional | | $32.36 | $33.11 | $776.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,174.90 / $10,715.19 / $17,378.01
| Facility | | $1,174.90 | $10,715.19 | $17,378.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $794.33 / $1,513.56 / $2,398.83
| Professional | | $794.33 | $1,513.56 | $2,398.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $912.01 / $1,202.26 / $2,089.30
| Professional | | $912.01 | $1,202.26 | $2,089.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $26,915.35 / $26,915.35 / $39,810.72
| Facility | | $26,915.35 | $26,915.35 | $39,810.72 |
- Facility/Professional
- Facility
- Modifier
- 52
- Typical Low / Median / Typical High
- $21,379.62 / $21,379.62 / $31,622.78
| Facility | 52 | $21,379.62 | $21,379.62 | $31,622.78 |
- Facility/Professional
- Facility
- Modifier
- 53
- Typical Low / Median / Typical High
- $5,370.32 / $5,370.32 / $7,943.28
| Facility | 53 | $5,370.32 | $5,370.32 | $7,943.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $812.83 / $2,754.23 / $3,548.13
| Professional | | $812.83 | $2,754.23 | $3,548.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,884.03 / $2,884.03 / $2,884.03
| Professional | | $2,884.03 | $2,884.03 | $2,884.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $27,542.29 / $33,113.11 / $38,018.94
| Facility | | $27,542.29 | $33,113.11 | $38,018.94 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,570.40 / $3,801.89 / $4,466.84
| Professional | | $2,570.40 | $3,801.89 | $4,466.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8,912.51 / $14,454.40 / $28,183.83
| Facility | | $8,912.51 | $14,454.40 | $28,183.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $616.60 / $1,096.48 / $2,454.71
| Professional | | $616.60 | $1,096.48 | $2,454.71 |