- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $22,387.21 / $56,234.13 / $56,234.13
| Facility | | $22,387.21 | $56,234.13 | $56,234.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10,000.00 / $13,803.84 / $19,952.62
| Professional | | $10,000.00 | $13,803.84 | $19,952.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $17,378.01 / $22,387.21 / $38,018.94
| Facility | | $17,378.01 | $22,387.21 | $38,018.94 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $23,988.33 / $25,118.86 / $25,118.86
| Professional | | $23,988.33 | $25,118.86 | $25,118.86 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13,182.57 / $13,182.57 / $14,791.08
| Facility | | $13,182.57 | $13,182.57 | $14,791.08 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10,964.78 / $10,964.78 / $13,182.57
| Professional | | $10,964.78 | $10,964.78 | $13,182.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,760.83 / $19,054.61 / $26,915.35
| Facility | | $6,760.83 | $19,054.61 | $26,915.35 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14,791.08 / $21,877.62 / $22,908.68
| Professional | | $14,791.08 | $21,877.62 | $22,908.68 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $30.20 / $30.20 / $19,498.45
| Professional | | $30.20 | $30.20 | $19,498.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16,218.10 / $16,218.10 / $23,988.33
| Professional | | $16,218.10 | $16,218.10 | $23,988.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $17,782.79 / $22,908.68 / $23,988.33
| Professional | | $17,782.79 | $22,908.68 | $23,988.33 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13,803.84 / $15,848.93 / $16,218.10
| Facility | | $13,803.84 | $15,848.93 | $16,218.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9,549.93 / $10,471.29 / $16,218.10
| Professional | | $9,549.93 | $10,471.29 | $16,218.10 |