- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14,454.40 / $14,454.40 / $14,454.40
| Facility | | $14,454.40 | $14,454.40 | $14,454.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,630.78 / $4,168.69 / $5,011.87
| Professional | | $3,630.78 | $4,168.69 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5,248.07 / $10,471.29 / $28,840.32
| Professional | | $5,248.07 | $10,471.29 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14,454.40 / $16,982.44 / $26,915.35
| Facility | | $14,454.40 | $16,982.44 | $26,915.35 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6,025.60 / $13,182.57 / $16,218.10
| Professional | | $6,025.60 | $13,182.57 | $16,218.10 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,754.40 / $21,877.62 / $33,113.11
| Facility | | $5,754.40 | $21,877.62 | $33,113.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $31,622.78 / $31,622.78 / $34,673.69
| Professional | | $31,622.78 | $31,622.78 | $34,673.69 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,677.35 / $6,760.83 / $18,197.01
| Facility | | $4,677.35 | $6,760.83 | $18,197.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,344.23 / $3,162.28 / $16,218.10
| Professional | | $2,344.23 | $3,162.28 | $16,218.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $50.12 / $70.79 / $5,011.87
| Professional | | $50.12 | $70.79 | $5,011.87 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,623.41 / $6,309.57 / $15,135.61
| Facility | | $5,623.41 | $6,309.57 | $15,135.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5,248.07 / $7,762.47 / $8,912.51
| Professional | | $5,248.07 | $7,762.47 | $8,912.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8,511.38 / $12,302.69 / $17,378.01
| Professional | | $8,511.38 | $12,302.69 | $17,378.01 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10,471.29 / $24,547.09 / $24,547.09
| Facility | | $10,471.29 | $24,547.09 | $24,547.09 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7,585.78 / $20,892.96 / $26,302.68
| Professional | | $7,585.78 | $20,892.96 | $26,302.68 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11,220.18 / $11,220.18 / $11,220.18
| Professional | | $11,220.18 | $11,220.18 | $11,220.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $28,840.32 / $28,840.32 / $28,840.32
| Professional | | $28,840.32 | $28,840.32 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,862.09 / $4,168.69 / $11,220.18
| Facility | | $1,862.09 | $4,168.69 | $11,220.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,187.76 / $3,162.28 / $7,943.28
| Professional | | $2,187.76 | $3,162.28 | $7,943.28 |