- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9,120.11 / $9,120.11 / $9,120.11
| Facility | | $9,120.11 | $9,120.11 | $9,120.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7,762.47 / $9,120.11 / $15,135.61
| Professional | | $7,762.47 | $9,120.11 | $15,135.61 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $18,620.87 / $18,620.87 / $30,199.52
| Facility | | $18,620.87 | $18,620.87 | $30,199.52 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $17,378.01 / $17,378.01 / $20,417.38
| Professional | | $17,378.01 | $17,378.01 | $20,417.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11,748.98 / $42,657.95 / $91,201.08
| Facility | | $11,748.98 | $42,657.95 | $91,201.08 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8,511.38 / $26,302.68 / $34,673.69
| Professional | | $8,511.38 | $26,302.68 | $34,673.69 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9,120.11 / $14,791.08 / $22,908.68
| Facility | | $9,120.11 | $14,791.08 | $22,908.68 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10,471.29 / $17,782.79 / $21,877.62
| Professional | | $10,471.29 | $17,782.79 | $21,877.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9,120.11 / $18,197.01 / $87,096.36
| Facility | | $9,120.11 | $18,197.01 | $87,096.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8,511.38 / $12,022.64 / $20,417.38
| Professional | | $8,511.38 | $12,022.64 | $20,417.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $54.95 / $70.79 / $12,302.69
| Professional | | $54.95 | $70.79 | $12,302.69 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $29,512.09 / $29,512.09 / $29,512.09
| Facility | | $29,512.09 | $29,512.09 | $29,512.09 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13,182.57 / $20,892.96 / $36,307.81
| Professional | | $13,182.57 | $20,892.96 | $36,307.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $18,620.87 / $27,542.29 / $53,703.18
| Professional | | $18,620.87 | $27,542.29 | $53,703.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11,748.98 / $37,153.52 / $87,096.36
| Facility | | $11,748.98 | $37,153.52 | $87,096.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8,511.38 / $16,982.44 / $112,201.85
| Professional | | $8,511.38 | $16,982.44 | $112,201.85 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8,912.51 / $12,882.50 / $18,620.87
| Facility | | $8,912.51 | $12,882.50 | $18,620.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7,079.46 / $9,120.11 / $15,488.17
| Professional | | $7,079.46 | $9,120.11 | $15,488.17 |