- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $67.61 / $758.58 / $3,630.78
| Facility | | $67.61 | $758.58 | $3,630.78 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $562.34 / $1,096.48 / $3,162.28
| Facility | 50 | $562.34 | $1,096.48 | $3,162.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $43.65 / $77.62 / $151.36
| Professional | | $43.65 | $77.62 | $151.36 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $66.07 / $114.82 / $263.03
| Professional | 50 | $66.07 | $114.82 | $263.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $47.86 / $63.10 / $87.10
| Professional | | $47.86 | $63.10 | $87.10 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $77.62 / $95.50 / $125.89
| Professional | 50 | $77.62 | $95.50 | $125.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,258.93 / $2,137.96 / $2,951.21
| Facility | | $1,258.93 | $2,137.96 | $2,951.21 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $38.90 / $61.66 / $102.33
| Professional | | $38.90 | $61.66 | $102.33 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $57.54 / $93.33 / $154.88
| Professional | 50 | $57.54 | $93.33 | $154.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $41.69 / $53.70 / $70.79
| Facility | | $41.69 | $53.70 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $52.48 / $69.18 / $89.13
| Professional | | $52.48 | $69.18 | $89.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $34.67 / $77.62 / $77.62
| Facility | | $34.67 | $77.62 | $77.62 |
- 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
- $52.48 / $87.10 / $416.87
| Professional | | $52.48 | $87.10 | $416.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $89.13
| Professional | | $32.36 | $33.11 | $89.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $58.88 / $724.44 / $1,949.84
| Facility | | $58.88 | $724.44 | $1,949.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $44.67 / $70.79 / $109.65
| Professional | | $44.67 | $70.79 | $109.65 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $79.43 / $79.43 / $85.11
| Professional | 50 | $79.43 | $79.43 | $85.11 |