- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10,000.00 / $44,668.36 / $87,096.36
| Facility | | $10,000.00 | $44,668.36 | $87,096.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10,000.00 / $11,220.18 / $19,952.62
| Professional | | $10,000.00 | $11,220.18 | $19,952.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,162.28 / $3,388.44 / $4,168.69
| Facility | | $3,162.28 | $3,388.44 | $4,168.69 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $17,378.01 / $17,378.01 / $23,442.29
| Facility | | $17,378.01 | $17,378.01 | $23,442.29 |
- 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
- $13,182.57 / $13,182.57 / $13,182.57
| Facility | | $13,182.57 | $13,182.57 | $13,182.57 |
- 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
- $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 / $173,780.08 / $173,780.08
| Professional | | $117,489.76 | $173,780.08 | $173,780.08 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10,000.00 / $19,054.61 / $29,512.09
| Facility | | $10,000.00 | $19,054.61 | $29,512.09 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10,000.00 / $11,748.98 / $22,908.68
| Professional | | $10,000.00 | $11,748.98 | $22,908.68 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19,498.45 / $19,498.45 / $19,498.45
| Professional | | $19,498.45 | $19,498.45 | $19,498.45 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10,232.93 / $17,782.79 / $28,840.32
| Facility | | $10,232.93 | $17,782.79 | $28,840.32 |
- 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
- $8,709.64 / $14,454.40 / $16,218.10
| Facility | | $8,709.64 | $14,454.40 | $16,218.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8,709.64 / $12,882.50 / $15,848.93
| Professional | | $8,709.64 | $12,882.50 | $15,848.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12,589.25 / $23,442.29 / $23,442.29
| Professional | | $12,589.25 | $23,442.29 | $23,442.29 |