- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16,595.87 / $17,378.01 / $18,620.87
| Facility | | $16,595.87 | $17,378.01 | $18,620.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9,549.93 / $11,748.98 / $19,054.61
| Professional | | $9,549.93 | $11,748.98 | $19,054.61 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14,454.40 / $14,454.40 / $25,118.86
| Facility | | $14,454.40 | $14,454.40 | $25,118.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14,454.40 / $26,302.68 / $32,359.37
| Professional | | $14,454.40 | $26,302.68 | $32,359.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $21,379.62 / $22,387.21 / $26,915.35
| Professional | | $21,379.62 | $22,387.21 | $26,915.35 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15,135.61 / $28,840.32 / $104,712.85
| Facility | | $15,135.61 | $28,840.32 | $104,712.85 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10,471.29 / $15,135.61 / $37,153.52
| Professional | | $10,471.29 | $15,135.61 | $37,153.52 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $24,547.09 / $25,703.96 / $30,199.52
| Professional | | $24,547.09 | $25,703.96 | $30,199.52 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $25,118.86 / $25,118.86 / $25,118.86
| Facility | | $25,118.86 | $25,118.86 | $25,118.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $22,908.68 / $37,153.52 / $37,153.52
| Professional | | $22,908.68 | $37,153.52 | $37,153.52 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10,000.00 / $22,908.68 / $53,703.18
| Facility | | $10,000.00 | $22,908.68 | $53,703.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10,232.93 / $12,022.64 / $21,379.62
| Professional | | $10,232.93 | $12,022.64 | $21,379.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $17,378.01 / $21,877.62 / $21,877.62
| Professional | | $17,378.01 | $21,877.62 | $21,877.62 |