- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $72.44 / $602.56 / $3,890.45
| Facility | | $72.44 | $602.56 | $3,890.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $48.98 / $87.10 / $173.78
| Professional | | $48.98 | $87.10 | $173.78 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $141.25 / $229.09 / $676.08
| Professional | 50 | $141.25 | $229.09 | $676.08 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $77.62 / $83.18 / $93.33
| Professional | | $77.62 | $83.18 | $93.33 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $89.13 / $181.97 / $186.21
| Professional | 50 | $89.13 | $181.97 | $186.21 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,801.89 / $10,715.19 / $11,220.18
| Facility | | $3,801.89 | $10,715.19 | $11,220.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $43.65 / $54.95 / $83.18
| Professional | | $43.65 | $54.95 | $83.18 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $64.57 / $83.18 / $123.03
| Professional | 50 | $64.57 | $83.18 | $123.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $48.98 / $63.10 / $81.28
| Facility | | $48.98 | $63.10 | $81.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $60.26 / $95.50 / $117.49
| Professional | | $60.26 | $95.50 | $117.49 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $34.67 / $89.13 / $89.13
| Facility | | $34.67 | $89.13 | $89.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $60.26 / $102.33 / $416.87
| Professional | | $60.26 | $102.33 | $416.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $64.57
| Professional | | $32.36 | $33.11 | $64.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $389.05 / $1,445.44 / $2,630.27
| Facility | | $389.05 | $1,445.44 | $2,630.27 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $53.70 / $85.11 / $141.25
| Professional | | $53.70 | $85.11 | $141.25 |