- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8,709.64 / $17,378.01 / $22,908.68
| Facility | | $8,709.64 | $17,378.01 | $22,908.68 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8,128.31 / $8,511.38 / $8,709.64
| Professional | | $8,128.31 | $8,511.38 | $8,709.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8,511.38 / $8,511.38 / $14,125.38
| Professional | | $8,511.38 | $8,511.38 | $14,125.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8,128.31 / $8,128.31 / $8,511.38
| Professional | | $8,128.31 | $8,128.31 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8,912.51 / $16,218.10 / $22,387.21
| Facility | | $8,912.51 | $16,218.10 | $22,387.21 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8,912.51 / $8,912.51 / $8,912.51
| Professional | | $8,912.51 | $8,912.51 | $8,912.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $302.00 / $426.58 / $9,549.93
| Professional | | $302.00 | $426.58 | $9,549.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $295.12 / $309.03 / $309.03
| Professional | | $295.12 | $309.03 | $309.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $407.38 / $8,709.64 / $13,182.57
| Facility | | $407.38 | $8,709.64 | $13,182.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $144.54 / $7,762.47 / $8,709.64
| Professional | | $144.54 | $7,762.47 | $8,709.64 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8,317.64 / $9,549.93 / $12,882.50
| Facility | | $8,317.64 | $9,549.93 | $12,882.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8,317.64 / $9,549.93 / $12,882.50
| Professional | | $8,317.64 | $9,549.93 | $12,882.50 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8,709.64 / $16,595.87 / $21,877.62
| Facility | | $8,709.64 | $16,595.87 | $21,877.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8,709.64 / $9,332.54 / $10,000.00
| Professional | | $8,709.64 | $9,332.54 | $10,000.00 |