- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $21,877.62 / $23,442.29 / $23,988.33
| Facility | | $21,877.62 | $23,442.29 | $23,988.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $21,877.62 / $23,442.29 / $25,118.86
| Professional | | $21,877.62 | $23,442.29 | $25,118.86 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,162.28 / $4,265.80 / $6,165.95
| Facility | | $3,162.28 | $4,265.80 | $6,165.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,162.28 / $3,162.28 / $5,495.41
| Professional | | $3,162.28 | $3,162.28 | $5,495.41 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $25,703.96 / $38,018.94 / $56,234.13
| Facility | | $25,703.96 | $38,018.94 | $56,234.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $23,988.33 / $23,988.33 / $23,988.33
| Professional | | $23,988.33 | $23,988.33 | $23,988.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,570.40 / $2,570.40 / $2,570.40
| Professional | | $2,570.40 | $2,570.40 | $2,570.40 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,090.30 / $23,442.29 / $30,902.95
| Facility | | $3,090.30 | $23,442.29 | $30,902.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.60 / $0.60 / $0.60
| Professional | | $0.60 | $0.60 | $0.60 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $23,988.33 / $39,810.72 / $44,668.36
| Facility | | $23,988.33 | $39,810.72 | $44,668.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $22,908.68 / $24,547.09 / $25,703.96
| Professional | | $22,908.68 | $24,547.09 | $25,703.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $120,226.44 / $120,226.44 / $120,226.44
| Facility | | $120,226.44 | $120,226.44 | $120,226.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $125,892.54 / $125,892.54 / $125,892.54
| Professional | | $125,892.54 | $125,892.54 | $125,892.54 |