- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $831.76 / $8,317.64 / $13,489.63
| Facility | | $831.76 | $8,317.64 | $13,489.63 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $21,877.62 / $21,877.62 / $21,877.62
| Facility | 50 | $21,877.62 | $21,877.62 | $21,877.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $407.38 / $588.84 / $1,000.00
| Professional | | $407.38 | $588.84 | $1,000.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,698.24 / $3,715.35 / $9,772.37
| Facility | | $1,698.24 | $3,715.35 | $9,772.37 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $2,570.40 / $5,248.07 / $14,791.08
| Facility | 50 | $2,570.40 | $5,248.07 | $14,791.08 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $794.33 / $912.01 / $1,122.02
| Professional | | $794.33 | $912.01 | $1,122.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $549.54 / $707.95 / $977.24
| Professional | | $549.54 | $707.95 | $977.24 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $501.19 / $870.96 / $8,317.64
| Facility | | $501.19 | $870.96 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $21,877.62 / $21,877.62 / $21,877.62
| Facility | 50 | $21,877.62 | $21,877.62 | $21,877.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $501.19 / $851.14 / $1,202.26
| Professional | | $501.19 | $851.14 | $1,202.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $32.36 / $33.11
| Professional | | $32.36 | $32.36 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,165.95 / $8,511.38 / $12,022.64
| Facility | | $6,165.95 | $8,511.38 | $12,022.64 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $9,120.11 / $13,182.57 / $18,197.01
| Facility | 50 | $9,120.11 | $13,182.57 | $18,197.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $707.95 / $794.33 / $933.25
| Professional | | $707.95 | $794.33 | $933.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $575.44 / $794.33 / $7,079.46
| Professional | | $575.44 | $794.33 | $7,079.46 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,495.41 / $12,302.69 / $12,302.69
| Facility | | $5,495.41 | $12,302.69 | $12,302.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $446.68 / $691.83 / $954.99
| Professional | | $446.68 | $691.83 | $954.99 |