- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14,454.40 / $14,454.40 / $14,454.40
| Facility | | $14,454.40 | $14,454.40 | $14,454.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12,589.25 / $14,454.40 / $23,988.33
| Professional | | $12,589.25 | $14,454.40 | $23,988.33 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $29,512.09 / $29,512.09 / $48,977.88
| Facility | | $29,512.09 | $29,512.09 | $48,977.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $27,542.29 / $27,542.29 / $33,113.11
| Professional | | $27,542.29 | $27,542.29 | $33,113.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16,595.87 / $67,608.30 / $144,543.98
| Facility | | $16,595.87 | $67,608.30 | $144,543.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12,022.64 / $41,686.94 / $56,234.13
| Professional | | $12,022.64 | $41,686.94 | $56,234.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14,454.40 / $23,988.33 / $34,673.69
| Facility | | $14,454.40 | $23,988.33 | $34,673.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $26,302.68 / $28,840.32 / $34,673.69
| Professional | | $26,302.68 | $28,840.32 | $34,673.69 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16,595.87 / $28,840.32 / $134,896.29
| Facility | | $16,595.87 | $28,840.32 | $134,896.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13,182.57 / $19,054.61 / $33,113.11
| Professional | | $13,182.57 | $19,054.61 | $33,113.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $54.95 / $64.57 / $85.11
| Professional | | $54.95 | $64.57 | $85.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $46,773.51 / $46,773.51 / $46,773.51
| Facility | | $46,773.51 | $46,773.51 | $46,773.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $20,892.96 / $34,673.69 / $57,543.99
| Professional | | $20,892.96 | $34,673.69 | $57,543.99 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $29,512.09 / $43,651.58 / $81,283.05
| Professional | | $29,512.09 | $43,651.58 | $81,283.05 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16,595.87 / $58,884.37 / $134,896.29
| Facility | | $16,595.87 | $58,884.37 | $134,896.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12,022.64 / $23,988.33 / $144,543.98
| Professional | | $12,022.64 | $23,988.33 | $144,543.98 |
- 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
- $11,220.18 / $14,454.40 / $23,988.33
| Professional | | $11,220.18 | $14,454.40 | $23,988.33 |