- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,096.48 / $2,187.76 / $18,620.87
| Facility | | $1,096.48 | $2,187.76 | $18,620.87 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $3,019.95 / $9,120.11 / $13,803.84
| Facility | 50 | $3,019.95 | $9,120.11 | $13,803.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $602.56 / $870.96 / $2,089.30
| Professional | | $602.56 | $870.96 | $2,089.30 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $1,412.54 / $2,041.74 / $4,897.79
| Professional | 50 | $1,412.54 | $2,041.74 | $4,897.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,918.31 / $10,232.93 / $20,892.96
| Facility | | $6,918.31 | $10,232.93 | $20,892.96 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $10,232.93 / $15,135.61 / $30,902.95
| Facility | 50 | $10,232.93 | $15,135.61 | $30,902.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $977.24 / $1,380.38 / $2,089.30
| Professional | | $977.24 | $1,380.38 | $2,089.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,187.76 / $2,187.76 / $3,630.78
| Facility | | $2,187.76 | $2,187.76 | $3,630.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $851.14 / $1,513.56 / $2,344.23
| Professional | | $851.14 | $1,513.56 | $2,344.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $933.25 / $1,659.59 / $3,801.89
| Facility | | $933.25 | $1,659.59 | $3,801.89 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $6,456.54 / $12,589.25 / $26,915.35
| Facility | 50 | $6,456.54 | $12,589.25 | $26,915.35 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $933.25 / $1,621.81 / $2,344.23
| Professional | | $933.25 | $1,621.81 | $2,344.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $309.03
| Professional | | $32.36 | $33.11 | $309.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $954.99 / $1,584.89 / $1,659.59
| Facility | | $954.99 | $1,584.89 | $1,659.59 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,122.02 / $1,122.02 / $1,148.15
| Facility | | $1,122.02 | $1,122.02 | $1,148.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $933.25 / $1,412.54 / $2,089.30
| Professional | | $933.25 | $1,412.54 | $2,089.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7,079.46 / $10,471.29 / $20,892.96
| Facility | | $7,079.46 | $10,471.29 | $20,892.96 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $10,471.29 / $15,848.93 / $30,902.95
| Facility | 50 | $10,471.29 | $15,848.93 | $30,902.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $977.24 / $1,380.38 / $1,949.84
| Professional | | $977.24 | $1,380.38 | $1,949.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,691.53 / $12,022.64 / $22,387.21
| Facility | | $2,691.53 | $12,022.64 | $22,387.21 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $851.14 / $1,174.90 / $2,187.76
| Professional | | $851.14 | $1,174.90 | $2,187.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $676.08 / $1,023.29 / $1,288.25
| Professional | | $676.08 | $1,023.29 | $1,288.25 |