- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7,943.28 / $46,773.51 / $85,113.80
| Facility | | $7,943.28 | $46,773.51 | $85,113.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5,128.61 / $6,760.83 / $8,317.64
| Professional | | $5,128.61 | $6,760.83 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8,511.38 / $12,589.25 / $16,982.44
| Facility | | $8,511.38 | $12,589.25 | $16,982.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7,244.36 / $8,511.38 / $11,220.18
| Professional | | $7,244.36 | $8,511.38 | $11,220.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8,912.51 / $19,054.61 / $21,877.62
| Facility | | $8,912.51 | $19,054.61 | $21,877.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7,585.78 / $8,511.38 / $13,489.63
| Facility | | $7,585.78 | $8,511.38 | $13,489.63 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7,585.78 / $8,511.38 / $14,454.40
| Professional | | $7,585.78 | $8,511.38 | $14,454.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $75.86 / $75.86 / $75.86
| Professional | | $75.86 | $75.86 | $75.86 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8,511.38 / $8,511.38 / $8,912.51
| Facility | | $8,511.38 | $8,511.38 | $8,912.51 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8,511.38 / $13,489.63 / $28,183.83
| Facility | | $8,511.38 | $13,489.63 | $28,183.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7,585.78 / $7,585.78 / $10,232.93
| Professional | | $7,585.78 | $7,585.78 | $10,232.93 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8,912.51 / $12,882.50 / $22,387.21
| Facility | | $8,912.51 | $12,882.50 | $22,387.21 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7,244.36 / $8,511.38 / $11,220.18
| Professional | | $7,244.36 | $8,511.38 | $11,220.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8,511.38 / $10,232.93 / $10,232.93
| Facility | | $8,511.38 | $10,232.93 | $10,232.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,548.13 / $3,548.13 / $9,549.93
| Professional | | $3,548.13 | $3,548.13 | $9,549.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,801.89 / $8,511.38 / $15,135.61
| Professional | | $3,801.89 | $8,511.38 | $15,135.61 |