- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7,413.10 / $7,413.10 / $12,589.25
| Facility | | $7,413.10 | $7,413.10 | $12,589.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6,456.54 / $7,585.78 / $12,882.50
| Professional | | $6,456.54 | $7,585.78 | $12,882.50 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15,488.17 / $16,595.87 / $33,113.11
| Facility | | $15,488.17 | $16,595.87 | $33,113.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7,585.78 / $9,549.93 / $20,417.38
| Professional | | $7,585.78 | $9,549.93 | $20,417.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8,128.31 / $13,803.84 / $19,498.45
| Facility | | $8,128.31 | $13,803.84 | $19,498.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10,471.29 / $14,454.40 / $21,877.62
| Professional | | $10,471.29 | $14,454.40 | $21,877.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10,000.00 / $10,000.00 / $10,471.29
| Facility | | $10,000.00 | $10,000.00 | $10,471.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7,244.36 / $7,244.36 / $10,000.00
| Professional | | $7,244.36 | $7,244.36 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10,000.00 / $10,000.00 / $10,000.00
| Facility | | $10,000.00 | $10,000.00 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7,244.36 / $7,244.36 / $10,000.00
| Professional | | $7,244.36 | $7,244.36 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8,709.64 / $13,803.84 / $19,952.62
| Professional | | $8,709.64 | $13,803.84 | $19,952.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $18,620.87 / $18,620.87 / $18,620.87
| Facility | | $18,620.87 | $18,620.87 | $18,620.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14,791.08 / $17,378.01 / $32,359.37
| Professional | | $14,791.08 | $17,378.01 | $32,359.37 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,606.93 / $12,022.64 / $16,595.87
| Facility | | $6,606.93 | $12,022.64 | $16,595.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5,128.61 / $7,585.78 / $11,220.18
| Professional | | $5,128.61 | $7,585.78 | $11,220.18 |