- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,495.41 / $5,495.41 / $40,738.03
| Facility | | $5,495.41 | $5,495.41 | $40,738.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4,265.80 / $5,495.41 / $36,307.81
| Professional | | $4,265.80 | $5,495.41 | $36,307.81 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,168.69 / $5,248.07 / $22,387.21
| Facility | | $4,168.69 | $5,248.07 | $22,387.21 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5,495.41 / $5,495.41 / $14,791.08
| Professional | | $5,495.41 | $5,495.41 | $14,791.08 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,623.41 / $13,803.84 / $21,877.62
| Facility | | $5,623.41 | $13,803.84 | $21,877.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8,912.51 / $17,378.01 / $35,481.34
| Professional | | $8,912.51 | $17,378.01 | $35,481.34 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,365.16 / $6,606.93 / $6,606.93
| Facility | | $4,365.16 | $6,606.93 | $6,606.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4,786.30 / $4,786.30 / $6,606.93
| Professional | | $4,786.30 | $4,786.30 | $6,606.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,548.13 / $4,466.84 / $11,481.54
| Professional | | $3,548.13 | $4,466.84 | $11,481.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5,754.40 / $8,709.64 / $14,791.08
| Professional | | $5,754.40 | $8,709.64 | $14,791.08 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $47,863.01 / $47,863.01 / $47,863.01
| Facility | | $47,863.01 | $47,863.01 | $47,863.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $61,659.50 / $91,201.08 / $91,201.08
| Professional | | $61,659.50 | $91,201.08 | $91,201.08 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12,022.64 / $12,022.64 / $12,022.64
| Professional | | $12,022.64 | $12,022.64 | $12,022.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $54.95 / $54.95 / $70.79
| Professional | | $54.95 | $54.95 | $70.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,890.45 / $8,912.51 / $12,302.69
| Facility | | $3,890.45 | $8,912.51 | $12,302.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4,786.30 / $4,786.30 / $9,332.54
| Professional | | $4,786.30 | $4,786.30 | $9,332.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $17,782.79 / $17,782.79 / $17,782.79
| Professional | | $17,782.79 | $17,782.79 | $17,782.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $741.31 / $6,025.60 / $12,302.69
| Facility | | $741.31 | $6,025.60 | $12,302.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4,168.69 / $5,495.41 / $10,232.93
| Professional | | $4,168.69 | $5,495.41 | $10,232.93 |