- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $954.99 / $6,309.57 / $12,882.50
| Facility | | $954.99 | $6,309.57 | $12,882.50 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $0.91 / $18,197.01 / $31,622.78
| Facility | 50 | $0.91 | $18,197.01 | $31,622.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $562.34 / $933.25 / $4,466.84
| Professional | | $562.34 | $933.25 | $4,466.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $851.14 / $851.14 / $851.14
| Professional | | $851.14 | $851.14 | $851.14 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,187.76 / $4,466.84 / $8,709.64
| Facility | | $2,187.76 | $4,466.84 | $8,709.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $575.44 / $645.65 / $1,047.13
| Professional | | $575.44 | $645.65 | $1,047.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,949.84 / $1,949.84 / $2,511.89
| Facility | | $1,949.84 | $1,949.84 | $2,511.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $416.87 / $812.83 / $1,479.11
| Professional | | $416.87 | $812.83 | $1,479.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $562.34 / $794.33 / $1,445.44
| Facility | | $562.34 | $794.33 | $1,445.44 |
- 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
- $2,884.03 / $10,232.93 / $16,982.44
| Facility | | $2,884.03 | $10,232.93 | $16,982.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $512.86 / $676.08 / $1,348.96
| Professional | | $512.86 | $676.08 | $1,348.96 |