- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $933.25 / $3,715.35 / $16,218.10
| Facility | | $933.25 | $3,715.35 | $16,218.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $309.03 / $407.38 / $724.44
| Professional | | $309.03 | $407.38 | $724.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,023.29 / $2,398.83 / $3,311.31
| Facility | | $1,023.29 | $2,398.83 | $3,311.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $331.13 / $407.38 / $616.60
| Professional | | $331.13 | $407.38 | $616.60 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $323.59 / $323.59 / $323.59
| Facility | | $323.59 | $323.59 | $323.59 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13,182.57 / $17,782.79 / $36,307.81
| Facility | | $13,182.57 | $17,782.79 | $36,307.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $398.11 / $537.03 / $812.83
| Professional | | $398.11 | $537.03 | $812.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,398.83 / $2,398.83 / $2,398.83
| Facility | | $2,398.83 | $2,398.83 | $2,398.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,398.83 / $3,090.30 / $3,090.30
| Professional | | $2,398.83 | $3,090.30 | $3,090.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $380.19 / $1,995.26 / $10,964.78
| Facility | | $380.19 | $1,995.26 | $10,964.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $309.03 / $467.74 / $1,230.27
| Professional | | $309.03 | $467.74 | $1,230.27 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $295.12
| Professional | | $32.36 | $33.11 | $295.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $331.13 / $501.19 / $23,988.33
| Facility | | $331.13 | $501.19 | $23,988.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $398.11 / $537.03 / $794.33
| Professional | | $398.11 | $537.03 | $794.33 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $162.18 / $954.99 / $2,398.83
| Facility | | $162.18 | $954.99 | $2,398.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $338.84 / $457.09 / $691.83
| Professional | | $338.84 | $457.09 | $691.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $323.59 / $323.59 / $338.84
| Professional | | $323.59 | $323.59 | $338.84 |