- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,630.78 / $7,943.28 / $11,220.18
| Facility | | $3,630.78 | $7,943.28 | $11,220.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,630.78 / $4,897.79 / $7,943.28
| Professional | | $3,630.78 | $4,897.79 | $7,943.28 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10,000.00 / $10,000.00 / $19,952.62
| Facility | | $10,000.00 | $10,000.00 | $19,952.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7,943.28 / $7,943.28 / $18,197.01
| Professional | | $7,943.28 | $7,943.28 | $18,197.01 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7,585.78 / $8,317.64 / $8,317.64
| Facility | | $7,585.78 | $8,317.64 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8,317.64 / $8,317.64 / $8,317.64
| Professional | | $8,317.64 | $8,317.64 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7,943.28 / $7,943.28 / $53,703.18
| Facility | | $7,943.28 | $7,943.28 | $53,703.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6,760.83 / $6,760.83 / $11,748.98
| Professional | | $6,760.83 | $6,760.83 | $11,748.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10,000.00 / $16,595.87 / $38,904.51
| Facility | | $10,000.00 | $16,595.87 | $38,904.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6,606.93 / $10,715.19 / $19,054.61
| Professional | | $6,606.93 | $10,715.19 | $19,054.61 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,897.79 / $4,897.79 / $4,897.79
| Facility | | $4,897.79 | $4,897.79 | $4,897.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5,888.44 / $6,309.57 / $6,309.57
| Professional | | $5,888.44 | $6,309.57 | $6,309.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10,471.29 / $50,118.72 / $75,857.76
| Facility | | $10,471.29 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6,606.93 / $9,549.93 / $9,549.93
| Professional | | $6,606.93 | $9,549.93 | $9,549.93 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,715.35 / $6,760.83 / $27,542.29
| Facility | | $3,715.35 | $6,760.83 | $27,542.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,311.31 / $6,606.93 / $16,595.87
| Professional | | $3,311.31 | $6,606.93 | $16,595.87 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,897.79 / $5,623.41 / $5,888.44
| Facility | | $4,897.79 | $5,623.41 | $5,888.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5,623.41 / $5,888.44 / $6,309.57
| Professional | | $5,623.41 | $5,888.44 | $6,309.57 |