- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,715.35 / $9,120.11 / $22,387.21
| Facility | | $3,715.35 | $9,120.11 | $22,387.21 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,467.37 / $9,332.54 / $10,964.78
| Professional | | $3,467.37 | $9,332.54 | $10,964.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,025.60 / $10,715.19 / $17,782.79
| Facility | | $6,025.60 | $10,715.19 | $17,782.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,000.00 / $11,220.18 / $20,892.96
| Professional | | $1,000.00 | $11,220.18 | $20,892.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $83.18 / $1,621.81 / $25,703.96
| Facility | | $83.18 | $1,621.81 | $25,703.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $630.96 / $870.96 / $1,737.80
| Professional | | $630.96 | $870.96 | $1,737.80 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $47,863.01 / $47,863.01 / $47,863.01
| Facility | | $47,863.01 | $47,863.01 | $47,863.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $54,954.09 / $54,954.09 / $57,543.99
| Professional | | $54,954.09 | $54,954.09 | $57,543.99 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $630.96 / $741.31 / $1,230.27
| Professional | | $630.96 | $741.31 | $1,230.27 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $223,872.11 / $223,872.11 / $223,872.11
| Facility | | $223,872.11 | $223,872.11 | $223,872.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $60,255.96 / $60,255.96 / $60,255.96
| Professional | | $60,255.96 | $60,255.96 | $60,255.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $776.25 / $1,122.02 / $13,489.63
| Facility | | $776.25 | $1,122.02 | $13,489.63 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $691.83 / $691.83 / $691.83
| Professional | | $691.83 | $691.83 | $691.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9,549.93 / $17,378.01 / $38,904.51
| Facility | | $9,549.93 | $17,378.01 | $38,904.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5,248.07 / $11,481.54 / $22,387.21
| Professional | | $5,248.07 | $11,481.54 | $22,387.21 |