- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4,677.35 / $6,309.57 / $7,585.78
| Professional | | $4,677.35 | $6,309.57 | $7,585.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,949.84 / $2,754.23 / $3,090.30
| Facility | | $1,949.84 | $2,754.23 | $3,090.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $524.81 / $602.56 / $602.56
| Professional | | $524.81 | $602.56 | $602.56 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,456.54 / $6,456.54 / $6,456.54
| Facility | | $6,456.54 | $6,456.54 | $6,456.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,981.07 / $3,981.07 / $4,570.88
| Facility | | $3,981.07 | $3,981.07 | $4,570.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,388.44 / $3,388.44 / $3,981.07
| Professional | | $3,388.44 | $3,388.44 | $3,981.07 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $100.00 / $6,456.54 / $6,456.54
| Facility | | $100.00 | $6,456.54 | $6,456.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,162.28 / $5,370.32 / $7,244.36
| Facility | | $3,162.28 | $5,370.32 | $7,244.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4,677.35 / $7,413.10 / $7,413.10
| Professional | | $4,677.35 | $7,413.10 | $7,413.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $263.03 / $870.96 / $5,128.61
| Professional | | $263.03 | $870.96 | $5,128.61 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,630.78 / $5,495.41 / $6,456.54
| Facility | | $3,630.78 | $5,495.41 | $6,456.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,388.44 / $3,388.44 / $3,981.07
| Professional | | $3,388.44 | $3,388.44 | $3,981.07 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $281.84 / $1,445.44 / $3,981.07
| Facility | | $281.84 | $1,445.44 | $3,981.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,089.30 / $2,884.03 / $4,897.79
| Professional | | $2,089.30 | $2,884.03 | $4,897.79 |