- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $512.86 / $2,951.21 / $8,912.51
| Facility | | $512.86 | $2,951.21 | $8,912.51 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $6,760.83 / $6,760.83 / $6,760.83
| Facility | 50 | $6,760.83 | $6,760.83 | $6,760.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $467.74 / $630.96 / $1,318.26
| Professional | | $467.74 | $630.96 | $1,318.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,137.96 / $3,890.45 / $6,309.57
| Facility | | $2,137.96 | $3,890.45 | $6,309.57 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $3,801.89 / $5,754.40 / $10,964.78
| Facility | 50 | $3,801.89 | $5,754.40 | $10,964.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $851.14 / $1,318.26 / $1,905.46
| Professional | | $851.14 | $1,318.26 | $1,905.46 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,479.11 / $1,905.46 / $4,466.84
| Facility | | $1,479.11 | $1,905.46 | $4,466.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $912.01 / $1,548.82 / $2,290.87
| Professional | | $912.01 | $1,548.82 | $2,290.87 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,479.11 / $1,819.70 / $3,630.78
| Facility | | $1,479.11 | $1,819.70 | $3,630.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $912.01 / $1,288.25 / $2,041.74
| Professional | | $912.01 | $1,288.25 | $2,041.74 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $562.34 / $1,071.52 / $5,248.07
| Facility | | $562.34 | $1,071.52 | $5,248.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $537.03 / $1,071.52 / $2,511.89
| Professional | | $537.03 | $1,071.52 | $2,511.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,090.30 / $4,365.16 / $10,000.00
| Facility | | $3,090.30 | $4,365.16 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $524.81 / $1,071.52 / $2,089.30
| Professional | | $524.81 | $1,071.52 | $2,089.30 |