- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $18,197.01 / $18,197.01 / $18,197.01
| Facility | | $18,197.01 | $18,197.01 | $18,197.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8,317.64 / $18,197.01 / $123,026.88
| Professional | | $8,317.64 | $18,197.01 | $123,026.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25,118.86 / $28,183.83 / $28,183.83
| Professional | | $25,118.86 | $28,183.83 | $28,183.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16,218.10 / $16,218.10 / $32,359.37
| Facility | | $16,218.10 | $16,218.10 | $32,359.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16,218.10 / $33,884.42 / $50,118.72
| Professional | | $16,218.10 | $33,884.42 | $50,118.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $18,197.01 / $31,622.78 / $134,896.29
| Facility | | $18,197.01 | $31,622.78 | $134,896.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9,549.93 / $17,378.01 / $28,840.32
| Professional | | $9,549.93 | $17,378.01 | $28,840.32 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $31,622.78 / $31,622.78 / $77,624.71
| Professional | | $31,622.78 | $31,622.78 | $77,624.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $32,359.37 / $32,359.37 / $32,359.37
| Facility | | $32,359.37 | $32,359.37 | $32,359.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $39,810.72 / $72,443.60 / $77,624.71
| Professional | | $39,810.72 | $72,443.60 | $77,624.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16,982.44 / $19,952.62 / $30,199.52
| Facility | | $16,982.44 | $19,952.62 | $30,199.52 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10,471.29 / $14,454.40 / $22,387.21
| Professional | | $10,471.29 | $14,454.40 | $22,387.21 |