- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12,589.25 / $12,589.25 / $13,803.84
| Facility | | $12,589.25 | $12,589.25 | $13,803.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12,302.69 / $14,125.38 / $24,547.09
| Professional | | $12,302.69 | $14,125.38 | $24,547.09 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $17,378.01 / $17,378.01 / $17,378.01
| Professional | | $17,378.01 | $17,378.01 | $17,378.01 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $79.43 / $29,512.09 / $29,512.09
| Facility | | $79.43 | $29,512.09 | $29,512.09 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16,595.87 / $16,595.87 / $16,595.87
| Facility | | $16,595.87 | $16,595.87 | $16,595.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12,022.64 / $12,022.64 / $16,595.87
| Professional | | $12,022.64 | $12,022.64 | $16,595.87 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $138,038.43 / $138,038.43 / $138,038.43
| Facility | | $138,038.43 | $138,038.43 | $138,038.43 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $147,910.84 / $208,929.61 / $208,929.61
| Professional | | $147,910.84 | $208,929.61 | $208,929.61 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $537.03 / $23,442.29 / $36,307.81
| Facility | | $537.03 | $23,442.29 | $36,307.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12,589.25 / $14,454.40 / $28,183.83
| Professional | | $12,589.25 | $14,454.40 | $28,183.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $81.28 / $81.28 / $89.13
| Professional | | $81.28 | $81.28 | $89.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $537.03 / $21,877.62 / $36,307.81
| Facility | | $537.03 | $21,877.62 | $36,307.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12,022.64 / $12,022.64 / $16,595.87
| Professional | | $12,022.64 | $12,022.64 | $16,595.87 |
- 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
- $10,715.19 / $15,848.93 / $19,952.62
| Professional | | $10,715.19 | $15,848.93 | $19,952.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15,488.17 / $29,512.09 / $29,512.09
| Professional | | $15,488.17 | $29,512.09 | $29,512.09 |