- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,309.57 / $6,309.57 / $6,309.57
| Facility | | $6,309.57 | $6,309.57 | $6,309.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4,677.35 / $6,309.57 / $10,232.93
| Professional | | $4,677.35 | $6,309.57 | $10,232.93 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12,882.50 / $12,882.50 / $21,379.62
| Facility | | $12,882.50 | $12,882.50 | $21,379.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11,481.54 / $12,022.64 / $14,454.40
| Professional | | $11,481.54 | $12,022.64 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8,128.31 / $29,512.09 / $63,095.73
| Facility | | $8,128.31 | $29,512.09 | $63,095.73 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5,888.44 / $18,197.01 / $24,547.09
| Professional | | $5,888.44 | $18,197.01 | $24,547.09 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,165.95 / $10,471.29 / $15,848.93
| Facility | | $6,165.95 | $10,471.29 | $15,848.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7,244.36 / $11,481.54 / $15,135.61
| Professional | | $7,244.36 | $11,481.54 | $15,135.61 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,309.57 / $12,589.25 / $54,954.09
| Facility | | $6,309.57 | $12,589.25 | $54,954.09 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5,248.07 / $7,585.78 / $14,125.38
| Professional | | $5,248.07 | $7,585.78 | $14,125.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $54.95 / $70.79 / $8,511.38
| Professional | | $54.95 | $70.79 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $20,417.38 / $20,417.38 / $20,417.38
| Facility | | $20,417.38 | $20,417.38 | $20,417.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9,120.11 / $14,454.40 / $25,118.86
| Professional | | $9,120.11 | $14,454.40 | $25,118.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12,882.50 / $19,054.61 / $33,113.11
| Professional | | $12,882.50 | $19,054.61 | $33,113.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8,128.31 / $25,703.96 / $56,234.13
| Facility | | $8,128.31 | $25,703.96 | $56,234.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5,888.44 / $11,481.54 / $69,183.10
| Professional | | $5,888.44 | $11,481.54 | $69,183.10 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,248.07 / $7,943.28 / $12,882.50
| Facility | | $5,248.07 | $7,943.28 | $12,882.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4,365.16 / $6,309.57 / $10,715.19
| Professional | | $4,365.16 | $6,309.57 | $10,715.19 |