- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $95.50 / $426.58 / $3,890.45
| Facility | | $95.50 | $426.58 | $3,890.45 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $446.68 / $446.68 / $446.68
| Facility | 50 | $446.68 | $446.68 | $446.68 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $64.57 / $199.53 / $501.19
| Professional | | $64.57 | $199.53 | $501.19 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $169.82 / $245.47 / $660.69
| Professional | 50 | $169.82 | $245.47 | $660.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $51.29 / $66.07 / $213.80
| Professional | | $51.29 | $66.07 | $213.80 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9,549.93 / $10,715.19 / $11,220.18
| Facility | | $9,549.93 | $10,715.19 | $11,220.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $63.10 / $74.13 / $537.03
| Professional | | $63.10 | $74.13 | $537.03 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $95.50 / $112.20 / $812.83
| Professional | 50 | $95.50 | $112.20 | $812.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $61.66 / $85.11 / $102.33
| Facility | | $61.66 | $85.11 | $102.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $79.43 / $213.80 / $281.84
| Professional | | $79.43 | $213.80 | $281.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $34.67 / $114.82 / $131.83
| Facility | | $34.67 | $114.82 | $131.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $75.86 / $213.80 / $3,311.31
| Professional | | $75.86 | $213.80 | $3,311.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $165.96
| Professional | | $32.36 | $33.11 | $165.96 |
- 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
- $69.18 / $177.83 / $380.19
| Professional | | $69.18 | $177.83 | $380.19 |