- 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
- $14,125.38 / $18,197.01 / $123,026.88
| Professional | | $14,125.38 | $18,197.01 | $123,026.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25,118.86 / $27,542.29 / $28,183.83
| Professional | | $25,118.86 | $27,542.29 | $28,183.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16,595.87 / $16,595.87 / $32,359.37
| Facility | | $16,595.87 | $16,595.87 | $32,359.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16,595.87 / $33,113.11 / $48,977.88
| Professional | | $16,595.87 | $33,113.11 | $48,977.88 |
- 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 / $16,982.44 / $28,840.32
| Professional | | $9,549.93 | $16,982.44 | $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
- $12,022.64 / $19,952.62 / $29,512.09
| Facility | | $12,022.64 | $19,952.62 | $29,512.09 |
- 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 |