- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,000.00 / $3,715.35 / $8,128.31
| Facility | | $1,000.00 | $3,715.35 | $8,128.31 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $1,905.46 / $5,248.07 / $10,000.00
| Facility | 50 | $1,905.46 | $5,248.07 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $446.68 / $549.54 / $1,174.90
| Professional | | $446.68 | $549.54 | $1,174.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $309.03 / $501.19 / $912.01
| Professional | | $309.03 | $501.19 | $912.01 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,348.96 / $2,238.72 / $4,570.88
| Facility | | $1,348.96 | $2,238.72 | $4,570.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $426.58 / $501.19 / $794.33
| Professional | | $426.58 | $501.19 | $794.33 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $501.19 / $1,659.59 / $7,585.78
| Facility | | $501.19 | $1,659.59 | $7,585.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $295.12 / $549.54 / $851.14
| Professional | | $295.12 | $549.54 | $851.14 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $467.74 / $1,584.89 / $1,584.89
| Facility | | $467.74 | $1,584.89 | $1,584.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $870.96 / $870.96 / $870.96
| Facility | | $870.96 | $870.96 | $870.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $478.63 / $676.08 / $1,071.52
| Professional | | $478.63 | $676.08 | $1,071.52 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,370.32 / $50,118.72 / $50,118.72
| Facility | | $5,370.32 | $50,118.72 | $50,118.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,801.89 / $4,466.84 / $4,466.84
| Professional | | $3,801.89 | $4,466.84 | $4,466.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $501.19 / $977.24 / $6,309.57
| Facility | | $501.19 | $977.24 | $6,309.57 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $2,089.30 / $7,244.36 / $10,000.00
| Facility | 50 | $2,089.30 | $7,244.36 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $467.74 / $676.08 / $1,202.26
| Professional | | $467.74 | $676.08 | $1,202.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $478.63
| Professional | | $32.36 | $33.11 | $478.63 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,456.54 / $6,456.54 / $6,456.54
| Facility | | $6,456.54 | $6,456.54 | $6,456.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $616.60 / $1,778.28 / $1,862.09
| Professional | | $616.60 | $1,778.28 | $1,862.09 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $478.63 / $630.96 / $1,122.02
| Facility | | $478.63 | $630.96 | $1,122.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $478.63 / $676.08 / $1,071.52
| Professional | | $478.63 | $676.08 | $1,071.52 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,288.25 / $4,365.16 / $9,120.11
| Facility | | $1,288.25 | $4,365.16 | $9,120.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $398.11 / $537.03 / $831.76
| Professional | | $398.11 | $537.03 | $831.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $467.74 / $478.63 / $501.19
| Professional | | $467.74 | $478.63 | $501.19 |