- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10,471.29 / $10,471.29 / $16,982.44
| Facility | | $10,471.29 | $10,471.29 | $16,982.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8,317.64 / $10,471.29 / $16,595.87
| Professional | | $8,317.64 | $10,471.29 | $16,595.87 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $21,877.62 / $22,908.68 / $46,773.51
| Facility | | $21,877.62 | $22,908.68 | $46,773.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10,715.19 / $13,182.57 / $28,183.83
| Professional | | $10,715.19 | $13,182.57 | $28,183.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9,772.37 / $16,595.87 / $23,442.29
| Facility | | $9,772.37 | $16,595.87 | $23,442.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12,882.50 / $17,782.79 / $26,915.35
| Professional | | $12,882.50 | $17,782.79 | $26,915.35 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13,803.84 / $13,803.84 / $14,454.40
| Facility | | $13,803.84 | $13,803.84 | $14,454.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10,000.00 / $10,000.00 / $13,803.84
| Professional | | $10,000.00 | $10,000.00 | $13,803.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13,803.84 / $13,803.84 / $13,803.84
| Facility | | $13,803.84 | $13,803.84 | $13,803.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10,000.00 / $10,000.00 / $13,803.84
| Professional | | $10,000.00 | $10,000.00 | $13,803.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10,715.19 / $16,982.44 / $24,547.09
| Professional | | $10,715.19 | $16,982.44 | $24,547.09 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $19,952.62 / $19,952.62 / $19,952.62
| Facility | | $19,952.62 | $19,952.62 | $19,952.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $20,892.96 / $24,547.09 / $44,668.36
| Professional | | $20,892.96 | $24,547.09 | $44,668.36 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8,709.64 / $17,378.01 / $26,302.68
| Facility | | $8,709.64 | $17,378.01 | $26,302.68 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7,079.46 / $10,471.29 / $14,791.08
| Professional | | $7,079.46 | $10,471.29 | $14,791.08 |