- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10,232.93 / $10,232.93 / $10,964.78
| Facility | | $10,232.93 | $10,232.93 | $10,964.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8,912.51 / $10,964.78 / $19,054.61
| Professional | | $8,912.51 | $10,964.78 | $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
- $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
- Facility
- Modifier
- Typical Low / Median / Typical High
- $102,329.30 / $102,329.30 / $102,329.30
| Facility | | $102,329.30 | $102,329.30 | $102,329.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $117,489.76 / $144,543.98 / $144,543.98
| Professional | | $117,489.76 | $144,543.98 | $144,543.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9,120.11 / $17,782.79 / $28,840.32
| Facility | | $9,120.11 | $17,782.79 | $28,840.32 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9,549.93 / $11,220.18 / $22,387.21
| Professional | | $9,549.93 | $11,220.18 | $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
- $10,000.00 / $17,378.01 / $28,840.32
| Facility | | $10,000.00 | $17,378.01 | $28,840.32 |
- 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
- $8,709.64 / $15,135.61 / $22,387.21
| Facility | | $8,709.64 | $15,135.61 | $22,387.21 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7,943.28 / $11,748.98 / $14,791.08
| Professional | | $7,943.28 | $11,748.98 | $14,791.08 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11,481.54 / $23,442.29 / $23,442.29
| Professional | | $11,481.54 | $23,442.29 | $23,442.29 |