- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,698.24 / $8,511.38 / $51,286.14
| Facility | | $1,698.24 | $8,511.38 | $51,286.14 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $891.25 / $1,479.11 / $3,801.89
| Professional | | $891.25 | $1,479.11 | $3,801.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10,232.93 / $20,892.96 / $51,286.14
| Facility | | $10,232.93 | $20,892.96 | $51,286.14 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,071.52 / $1,348.96 / $2,137.96
| Professional | | $1,071.52 | $1,348.96 | $2,137.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $776.25 / $891.25 / $1,479.11
| Professional | | $776.25 | $891.25 | $1,479.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14,454.40 / $23,442.29 / $38,018.94
| Facility | | $14,454.40 | $23,442.29 | $38,018.94 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $933.25 / $1,548.82 / $2,511.89
| Professional | | $933.25 | $1,548.82 | $2,511.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,122.02 / $3,981.07 / $39,810.72
| Facility | | $1,122.02 | $3,981.07 | $39,810.72 |
- Facility/Professional
- Facility
- Modifier
- 53
- Typical Low / Median / Typical High
- $407.38 / $5,370.32 / $5,370.32
| Facility | 53 | $407.38 | $5,370.32 | $5,370.32 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,000.00 / $1,778.28 / $6,760.83
| Professional | | $1,000.00 | $1,778.28 | $6,760.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,388.44 / $4,466.84 / $23,442.29
| Facility | | $3,388.44 | $4,466.84 | $23,442.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,071.52 / $1,584.89 / $2,691.53
| Professional | | $1,071.52 | $1,584.89 | $2,691.53 |