- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10,000.00 / $10,000.00 / $10,964.78
| Facility | | $10,000.00 | $10,000.00 | $10,964.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8,128.31 / $10,471.29 / $19,054.61
| Professional | | $8,128.31 | $10,471.29 | $19,054.61 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $79.43 / $23,442.29 / $23,442.29
| Facility | | $79.43 | $23,442.29 | $23,442.29 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12,589.25 / $12,589.25 / $12,589.25
| Facility | | $12,589.25 | $12,589.25 | $12,589.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9,120.11 / $9,120.11 / $12,589.25
| Professional | | $9,120.11 | $9,120.11 | $12,589.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $93,325.43 / $93,325.43 / $93,325.43
| Facility | | $93,325.43 | $93,325.43 | $93,325.43 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $117,489.76 / $131,825.67 / $131,825.67
| Professional | | $117,489.76 | $131,825.67 | $131,825.67 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8,511.38 / $17,378.01 / $28,840.32
| Facility | | $8,511.38 | $17,378.01 | $28,840.32 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8,709.64 / $10,471.29 / $22,387.21
| Professional | | $8,709.64 | $10,471.29 | $22,387.21 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $17,378.01 / $17,378.01 / $17,782.79
| Professional | | $17,378.01 | $17,378.01 | $17,782.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9,332.54 / $17,378.01 / $28,840.32
| Facility | | $9,332.54 | $17,378.01 | $28,840.32 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9,120.11 / $9,120.11 / $12,589.25
| Professional | | $9,120.11 | $9,120.11 | $12,589.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7,943.28 / $13,489.63 / $20,417.38
| Facility | | $7,943.28 | $13,489.63 | $20,417.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7,244.36 / $10,715.19 / $13,489.63
| Professional | | $7,244.36 | $10,715.19 | $13,489.63 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10,715.19 / $23,442.29 / $23,442.29
| Professional | | $10,715.19 | $23,442.29 | $23,442.29 |