- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,071.52 / $4,897.79 / $15,135.61
| Facility | | $1,071.52 | $4,897.79 | $15,135.61 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $8,709.64 / $8,709.64 / $8,709.64
| Facility | 50 | $8,709.64 | $8,709.64 | $8,709.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $588.84 / $741.31 / $1,778.28
| Professional | | $588.84 | $741.31 | $1,778.28 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $741.31 / $2,041.74 / $3,890.45
| Professional | 50 | $741.31 | $2,041.74 | $3,890.45 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,238.72 / $5,011.87 / $16,218.10
| Facility | | $2,238.72 | $5,011.87 | $16,218.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $676.08 / $870.96 / $1,348.96
| Professional | | $676.08 | $870.96 | $1,348.96 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $1,000.00 / $1,318.26 / $2,041.74
| Professional | 50 | $1,000.00 | $1,318.26 | $2,041.74 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $630.96 / $912.01 / $1,230.27
| Professional | | $630.96 | $912.01 | $1,230.27 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7,413.10 / $13,803.84 / $15,848.93
| Facility | | $7,413.10 | $13,803.84 | $15,848.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $549.54 / $977.24 / $1,621.81
| Professional | | $549.54 | $977.24 | $1,621.81 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $616.60 / $1,412.54 / $26,302.68
| Facility | | $616.60 | $1,412.54 | $26,302.68 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $776.25 / $1,230.27 / $6,165.95
| Professional | | $776.25 | $1,230.27 | $6,165.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,819.70 / $2,818.38 / $4,897.79
| Facility | | $1,819.70 | $2,818.38 | $4,897.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $630.96 / $891.25 / $1,348.96
| Professional | | $630.96 | $891.25 | $1,348.96 |