- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,584.89 / $7,762.47 / $25,118.86
| Facility | | $1,584.89 | $7,762.47 | $25,118.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $794.33 / $1,047.13 / $1,995.26
| Professional | | $794.33 | $1,047.13 | $1,995.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $794.33 / $870.96 / $1,023.29
| Professional | | $794.33 | $870.96 | $1,023.29 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $20,417.38 / $52,480.75 / $97,723.72
| Facility | | $20,417.38 | $52,480.75 | $97,723.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $660.69 / $1,000.00 / $1,548.82
| Professional | | $660.69 | $1,000.00 | $1,548.82 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,011.87 / $30,199.52 / $58,884.37
| Facility | | $5,011.87 | $30,199.52 | $58,884.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $794.33 / $1,096.48 / $1,548.82
| Professional | | $794.33 | $1,096.48 | $1,548.82 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $794.33 / $22,387.21 / $22,387.21
| Facility | | $794.33 | $22,387.21 | $22,387.21 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10,000.00 / $22,908.68 / $56,234.13
| Facility | | $10,000.00 | $22,908.68 | $56,234.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,000.00 / $1,412.54 / $2,089.30
| Professional | | $1,000.00 | $1,412.54 | $2,089.30 |
- 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
- Facility
- Modifier
- Typical Low / Median / Typical High
- $977.24 / $4,365.16 / $20,892.96
| Facility | | $977.24 | $4,365.16 | $20,892.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $851.14 / $1,202.26 / $2,187.76
| Professional | | $851.14 | $1,202.26 | $2,187.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $741.31
| Professional | | $32.36 | $33.11 | $741.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $851.14 / $1,258.93 / $18,620.87
| Facility | | $851.14 | $1,258.93 | $18,620.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $977.24 / $1,412.54 / $2,041.74
| Professional | | $977.24 | $1,412.54 | $2,041.74 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,073.80 / $12,302.69 / $28,840.32
| Facility | | $4,073.80 | $12,302.69 | $28,840.32 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $891.25 / $1,230.27 / $1,949.84
| Professional | | $891.25 | $1,230.27 | $1,949.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $776.25 / $776.25 / $851.14
| Professional | | $776.25 | $776.25 | $851.14 |