- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $151.36 / $891.25 / $2,951.21
| Facility | | $151.36 | $891.25 | $2,951.21 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $645.65 / $954.99 / $1,949.84
| Facility | 50 | $645.65 | $954.99 | $1,949.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $58.88 / $117.49 / $338.84
| Professional | | $58.88 | $117.49 | $338.84 |
- Facility/Professional
- Professional
- Modifier
- 22
- Typical Low / Median / Typical High
- $173.78 / $173.78 / $173.78
| Professional | 22 | $173.78 | $173.78 | $173.78 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $138.04 / $302.00 / $741.31
| Professional | 50 | $138.04 | $302.00 | $741.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $56.23 / $537.03 / $2,818.38
| Facility | | $56.23 | $537.03 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $63.10 / $114.82 / $281.84
| Professional | | $63.10 | $114.82 | $281.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $67.61 / $67.61 / $154.88
| Facility | | $67.61 | $67.61 | $154.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $67.61 / $117.49 / $234.42
| Professional | | $67.61 | $117.49 | $234.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $69.18 / $125.89 / $245.47
| Professional | | $69.18 | $125.89 | $245.47 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $53.70 / $72.44 / $3,311.31
| Facility | | $53.70 | $72.44 | $3,311.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $117.49 / $144.54 / $181.97
| Professional | | $117.49 | $144.54 | $181.97 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $741.31 / $2,041.74 / $3,467.37
| Facility | | $741.31 | $2,041.74 | $3,467.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $60.26 / $125.89 / $269.15
| Professional | | $60.26 | $125.89 | $269.15 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $288.40 / $758.58 / $1,122.02
| Facility | | $288.40 | $758.58 | $1,122.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $93.33 / $169.82 / $794.33
| Professional | | $93.33 | $169.82 | $794.33 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $56.23 / $537.03 / $2,818.38
| Facility | | $56.23 | $537.03 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $63.10 / $114.82 / $281.84
| Professional | | $63.10 | $114.82 | $281.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $43.65 / $398.11 / $630.96
| Facility | | $43.65 | $398.11 | $630.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $70.79 / $109.65 / $199.53
| Professional | | $70.79 | $109.65 | $199.53 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $501.19 / $1,698.24 / $2,818.38
| Facility | | $501.19 | $1,698.24 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $66.07 / $125.89 / $269.15
| Professional | | $66.07 | $125.89 | $269.15 |