- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10,232.93 / $10,232.93 / $10,232.93
| Facility | | $10,232.93 | $10,232.93 | $10,232.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6,760.83 / $9,332.54 / $12,022.64
| Professional | | $6,760.83 | $9,332.54 | $12,022.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6,606.93 / $6,606.93 / $17,782.79
| Professional | | $6,606.93 | $6,606.93 | $17,782.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $41,686.94 / $48,977.88 / $77,624.71
| Facility | | $41,686.94 | $48,977.88 | $77,624.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11,220.18 / $19,498.45 / $23,988.33
| Professional | | $11,220.18 | $19,498.45 | $23,988.33 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,548.82 / $10,232.93 / $23,442.29
| Facility | | $1,548.82 | $10,232.93 | $23,442.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,412.54 / $1,548.82 / $8,912.51
| Professional | | $1,412.54 | $1,548.82 | $8,912.51 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,548.82 / $12,022.64 / $69,183.10
| Facility | | $1,548.82 | $12,022.64 | $69,183.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5,888.44 / $7,244.36 / $16,218.10
| Professional | | $5,888.44 | $7,244.36 | $16,218.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $58.88 / $575.44 / $2,754.23
| Professional | | $58.88 | $575.44 | $2,754.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7,585.78 / $11,220.18 / $23,988.33
| Professional | | $7,585.78 | $11,220.18 | $23,988.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,737.80 / $3,019.95 / $4,265.80
| Professional | | $1,737.80 | $3,019.95 | $4,265.80 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11,220.18 / $24,547.09 / $72,443.60
| Facility | | $11,220.18 | $24,547.09 | $72,443.60 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10,715.19 / $21,877.62 / $67,608.30
| Professional | | $10,715.19 | $21,877.62 | $67,608.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $660.69 / $4,897.79 / $8,709.64
| Facility | | $660.69 | $4,897.79 | $8,709.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5,248.07 / $7,244.36 / $11,748.98
| Professional | | $5,248.07 | $7,244.36 | $11,748.98 |