- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,715.35 / $3,715.35 / $17,782.79
| Facility | | $3,715.35 | $3,715.35 | $17,782.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,715.35 / $6,025.60 / $11,481.54
| Professional | | $3,715.35 | $6,025.60 | $11,481.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12,882.50 / $17,378.01 / $30,199.52
| Facility | | $12,882.50 | $17,378.01 | $30,199.52 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4,786.30 / $7,413.10 / $32,359.37
| Professional | | $4,786.30 | $7,413.10 | $32,359.37 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $29,512.09 / $33,884.42 / $54,954.09
| Facility | | $29,512.09 | $33,884.42 | $54,954.09 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $741.31 / $1,202.26 / $17,378.01
| Professional | | $741.31 | $1,202.26 | $17,378.01 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $660.69 / $3,715.35 / $21,379.62
| Facility | | $660.69 | $3,715.35 | $21,379.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,288.25 / $1,288.25 / $20,892.96
| Professional | | $1,288.25 | $1,288.25 | $20,892.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,318.26 / $12,589.25 / $22,908.68
| Facility | | $1,318.26 | $12,589.25 | $22,908.68 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11,481.54 / $19,498.45 / $47,863.01
| Professional | | $11,481.54 | $19,498.45 | $47,863.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $50.12 / $50.12 / $70.79
| Professional | | $50.12 | $50.12 | $70.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11,748.98 / $12,882.50 / $27,542.29
| Facility | | $11,748.98 | $12,882.50 | $27,542.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5,128.61 / $8,511.38 / $19,952.62
| Professional | | $5,128.61 | $8,511.38 | $19,952.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $24,547.09 / $24,547.09 / $38,018.94
| Facility | | $24,547.09 | $24,547.09 | $38,018.94 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7,585.78 / $47,863.01 / $47,863.01
| Professional | | $7,585.78 | $47,863.01 | $47,863.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,311.31 / $3,311.31 / $53,703.18
| Professional | | $3,311.31 | $3,311.31 | $53,703.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4,570.88 / $58,884.37 / $74,131.02
| Professional | | $4,570.88 | $58,884.37 | $74,131.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9,549.93 / $17,378.01 / $23,442.29
| Facility | | $9,549.93 | $17,378.01 | $23,442.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10,471.29 / $19,498.45 / $43,651.58
| Professional | | $10,471.29 | $19,498.45 | $43,651.58 |