- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $91.20 / $831.76 / $4,466.84
| Facility | | $91.20 | $831.76 | $4,466.84 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $398.11 / $954.99 / $3,467.37
| Facility | 50 | $398.11 | $954.99 | $3,467.37 |
- Facility/Professional
- Facility
- Modifier
- 52
- Typical Low / Median / Typical High
- $302.00 / $616.60 / $660.69
| Facility | 52 | $302.00 | $616.60 | $660.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $43.65 / $79.43 / $213.80
| Professional | | $43.65 | $79.43 | $213.80 |
- Facility/Professional
- Professional
- Modifier
- 22
- Typical Low / Median / Typical High
- $281.84 / $630.96 / $954.99
| Professional | 22 | $281.84 | $630.96 | $954.99 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $67.61 / $128.82 / $354.81
| Professional | 50 | $67.61 | $128.82 | $354.81 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,548.82 / $5,011.87 / $12,302.69
| Facility | | $1,548.82 | $5,011.87 | $12,302.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $47.86 / $77.62 / $147.91
| Professional | | $47.86 | $77.62 | $147.91 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $70.79 / $112.20 / $218.78
| Professional | 50 | $70.79 | $112.20 | $218.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $50.12 / $169.82 / $562.34
| Facility | | $50.12 | $169.82 | $562.34 |
- Facility/Professional
- Facility
- Modifier
- 52
- Typical Low / Median / Typical High
- $61.66 / $61.66 / $61.66
| Facility | 52 | $61.66 | $61.66 | $61.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $50.12 / $81.28 / $169.82
| Professional | | $50.12 | $81.28 | $169.82 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $245.47 / $1,047.13 / $3,467.37
| Facility | | $245.47 | $1,047.13 | $3,467.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $42.66 / $70.79 / $151.36
| Professional | | $42.66 | $70.79 | $151.36 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $79.43 / $85.11 / $154.88
| Professional | 50 | $79.43 | $85.11 | $154.88 |