- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,786.30 / $12,302.69 / $56,234.13
| Facility | | $4,786.30 | $12,302.69 | $56,234.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $891.25 / $1,258.93 / $4,570.88
| Professional | | $891.25 | $1,258.93 | $4,570.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $645.65 / $1,445.44 / $1,905.46
| Professional | | $645.65 | $1,445.44 | $1,905.46 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11,748.98 / $16,982.44 / $28,840.32
| Facility | | $11,748.98 | $16,982.44 | $28,840.32 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,513.56 / $2,187.76 / $3,981.07
| Professional | | $1,513.56 | $2,187.76 | $3,981.07 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $85.11 / $13,489.63 / $39,810.72
| Facility | | $85.11 | $13,489.63 | $39,810.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $954.99 / $1,412.54 / $3,311.31
| Professional | | $954.99 | $1,412.54 | $3,311.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13,182.57 / $21,877.62 / $33,113.11
| Facility | | $13,182.57 | $21,877.62 | $33,113.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,122.02 / $1,412.54 / $3,090.30
| Professional | | $1,122.02 | $1,412.54 | $3,090.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $831.76 / $870.96 / $1,659.59
| Professional | | $831.76 | $870.96 | $1,659.59 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $707.95 / $933.25 / $1,819.70
| Professional | | $707.95 | $933.25 | $1,819.70 |
- 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
- $114,815.36 / $114,815.36 / $114,815.36
| Facility | | $114,815.36 | $114,815.36 | $114,815.36 |
- Facility/Professional
- Facility
- Modifier
- 53
- Typical Low / Median / Typical High
- $22,908.68 / $22,908.68 / $22,908.68
| Facility | 53 | $22,908.68 | $22,908.68 | $22,908.68 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6,760.83 / $7,943.28 / $7,943.28
| Professional | | $6,760.83 | $7,943.28 | $7,943.28 |
- 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
- $912.01 / $1,348.96 / $22,908.68
| Facility | | $912.01 | $1,348.96 | $22,908.68 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,122.02 / $1,412.54 / $3,090.30
| Professional | | $1,122.02 | $1,412.54 | $3,090.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,548.13 / $3,548.13 / $3,548.13
| Professional | | $3,548.13 | $3,548.13 | $3,548.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $758.58 / $1,230.27 / $1,905.46
| Professional | | $758.58 | $1,230.27 | $1,905.46 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10,000.00 / $18,620.87 / $42,657.95
| Facility | | $10,000.00 | $18,620.87 | $42,657.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $912.01 / $1,380.38 / $3,090.30
| Professional | | $912.01 | $1,380.38 | $3,090.30 |