- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $831.76 / $5,623.41 / $8,912.51
| Facility | | $831.76 | $5,623.41 | $8,912.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $562.34 / $1,258.93 / $6,165.95
| Professional | | $562.34 | $1,258.93 | $6,165.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $549.54 / $1,148.15 / $3,467.37
| Facility | | $549.54 | $1,148.15 | $3,467.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $549.54 / $645.65 / $1,174.90
| Professional | | $549.54 | $645.65 | $1,174.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,071.52 / $1,318.26 / $1,621.81
| Professional | | $1,071.52 | $1,318.26 | $1,621.81 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $741.31 / $977.24 / $3,162.28
| Facility | | $741.31 | $977.24 | $3,162.28 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $8,317.64 / $8,317.64 / $8,317.64
| Facility | 50 | $8,317.64 | $8,317.64 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $524.81 / $1,096.48 / $6,456.54
| Professional | | $524.81 | $1,096.48 | $6,456.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,174.90 / $1,258.93 / $1,258.93
| Professional | | $1,174.90 | $1,258.93 | $1,258.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,174.90 / $1,174.90 / $1,230.27
| Professional | | $1,174.90 | $1,174.90 | $1,230.27 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $691.83 / $954.99 / $1,122.02
| Professional | | $691.83 | $954.99 | $1,122.02 |
- Facility/Professional
- Professional
- Modifier
- AS
- Typical Low / Median / Typical High
- $213.80 / $213.80 / $213.80
| Professional | AS | $213.80 | $213.80 | $213.80 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,162.28 / $3,162.28 / $6,760.83
| Facility | | $3,162.28 | $3,162.28 | $6,760.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $630.96 / $954.99 / $1,548.82
| Professional | | $630.96 | $954.99 | $1,548.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,096.48 / $1,348.96 / $1,348.96
| Professional | | $1,096.48 | $1,348.96 | $1,348.96 |