- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $44.67 / $371.54 / $7,943.28
| Facility | | $44.67 | $371.54 | $7,943.28 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $588.84 / $691.83 / $1,023.29
| Facility | 50 | $588.84 | $691.83 | $1,023.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $37.15 / $66.07 / $154.88
| Professional | | $37.15 | $66.07 | $154.88 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $81.28 / $114.82 / $186.21
| Professional | 50 | $81.28 | $114.82 | $186.21 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $53.70 / $58.88 / $85.11
| Professional | | $53.70 | $58.88 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $75.86 / $87.10 / $128.82
| Professional | 50 | $75.86 | $87.10 | $128.82 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $281.84 / $562.34 / $1,047.13
| Facility | | $281.84 | $562.34 | $1,047.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $34.67 / $54.95 / $79.43
| Professional | | $34.67 | $54.95 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $47.86 / $47.86 / $575.44
| Facility | | $47.86 | $47.86 | $575.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $45.71 / $67.61 / $104.71
| Professional | | $45.71 | $67.61 | $104.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $44.67 / $67.61 / $114.82
| Facility | | $44.67 | $67.61 | $114.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $33.11
| Professional | | $32.36 | $33.11 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $234.42 / $1,148.15 / $4,677.35
| Facility | | $234.42 | $1,148.15 | $4,677.35 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $34.67 / $52.48 / $89.13
| Professional | | $34.67 | $52.48 | $89.13 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $138.04 / $138.04 / $138.04
| Professional | 50 | $138.04 | $138.04 | $138.04 |