- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10,471.29 / $31,622.78 / $199,526.23
| Facility | | $10,471.29 | $31,622.78 | $199,526.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10,000.00 / $12,589.25 / $19,952.62
| Professional | | $10,000.00 | $12,589.25 | $19,952.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $19,498.45 / $19,498.45 / $19,498.45
| Facility | | $19,498.45 | $19,498.45 | $19,498.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19,498.45 / $19,498.45 / $25,118.86
| Professional | | $19,498.45 | $19,498.45 | $25,118.86 |
- 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
- $13,182.57 / $24,547.09 / $47,863.01
| Facility | | $13,182.57 | $24,547.09 | $47,863.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13,182.57 / $26,915.35 / $47,863.01
| Professional | | $13,182.57 | $26,915.35 | $47,863.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $64.57 / $21,877.62 / $23,988.33
| Professional | | $64.57 | $21,877.62 | $23,988.33 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $21,877.62 / $22,387.21 / $22,908.68
| Facility | | $21,877.62 | $22,387.21 | $22,908.68 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $18,620.87 / $19,952.62 / $36,307.81
| Facility | | $18,620.87 | $19,952.62 | $36,307.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $18,620.87 / $18,620.87 / $21,877.62
| Professional | | $18,620.87 | $18,620.87 | $21,877.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19,498.45 / $19,498.45 / $25,118.86
| Professional | | $19,498.45 | $19,498.45 | $25,118.86 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7,943.28 / $15,848.93 / $16,218.10
| Facility | | $7,943.28 | $15,848.93 | $16,218.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9,772.37 / $13,803.84 / $19,952.62
| Professional | | $9,772.37 | $13,803.84 | $19,952.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12,589.25 / $16,218.10 / $34,673.69
| Professional | | $12,589.25 | $16,218.10 | $34,673.69 |