- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15,848.93 / $15,848.93 / $17,782.79
| Facility | | $15,848.93 | $15,848.93 | $17,782.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8,317.64 / $11,220.18 / $16,595.87
| Professional | | $8,317.64 | $11,220.18 | $16,595.87 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13,803.84 / $13,803.84 / $22,908.68
| Facility | | $13,803.84 | $13,803.84 | $22,908.68 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13,803.84 / $24,547.09 / $30,902.95
| Professional | | $13,803.84 | $24,547.09 | $30,902.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $18,197.01 / $20,892.96 / $22,387.21
| Professional | | $18,197.01 | $20,892.96 | $22,387.21 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13,803.84 / $26,302.68 / $100,000.00
| Facility | | $13,803.84 | $26,302.68 | $100,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9,549.93 / $14,454.40 / $33,884.42
| Professional | | $9,549.93 | $14,454.40 | $33,884.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $22,387.21 / $23,442.29 / $28,840.32
| Professional | | $22,387.21 | $23,442.29 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $22,908.68 / $22,908.68 / $22,908.68
| Facility | | $22,908.68 | $22,908.68 | $22,908.68 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $21,877.62 / $33,884.42 / $33,884.42
| Professional | | $21,877.62 | $33,884.42 | $33,884.42 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9,549.93 / $20,892.96 / $51,286.14
| Facility | | $9,549.93 | $20,892.96 | $51,286.14 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9,549.93 / $10,964.78 / $19,498.45
| Professional | | $9,549.93 | $10,964.78 | $19,498.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15,848.93 / $19,952.62 / $19,952.62
| Professional | | $15,848.93 | $19,952.62 | $19,952.62 |