- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12,302.69 / $26,302.68 / $47,863.01
| Facility | | $12,302.69 | $26,302.68 | $47,863.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10,000.00 / $12,302.69 / $17,782.79
| Professional | | $10,000.00 | $12,302.69 | $17,782.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12,589.25 / $12,589.25 / $26,302.68
| Professional | | $12,589.25 | $12,589.25 | $26,302.68 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15,135.61 / $15,135.61 / $15,135.61
| Professional | | $15,135.61 | $15,135.61 | $15,135.61 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8,511.38 / $13,182.57 / $13,182.57
| Facility | | $8,511.38 | $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
- Professional
- Modifier
- Typical Low / Median / Typical High
- $17,782.79 / $23,988.33 / $33,113.11
| Professional | | $17,782.79 | $23,988.33 | $33,113.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11,748.98 / $15,488.17 / $23,442.29
| Professional | | $11,748.98 | $15,488.17 | $23,442.29 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9,772.37 / $16,218.10 / $26,915.35
| Facility | | $9,772.37 | $16,218.10 | $26,915.35 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12,882.50 / $14,125.38 / $15,488.17
| Professional | | $12,882.50 | $14,125.38 | $15,488.17 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12,882.50 / $19,054.61 / $33,113.11
| Facility | | $12,882.50 | $19,054.61 | $33,113.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12,882.50 / $19,054.61 / $33,113.11
| Professional | | $12,882.50 | $19,054.61 | $33,113.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7,943.28 / $15,488.17 / $16,218.10
| Facility | | $7,943.28 | $15,488.17 | $16,218.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10,715.19 / $11,748.98 / $18,620.87
| Professional | | $10,715.19 | $11,748.98 | $18,620.87 |