- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $316.23 / $6,918.31 / $22,908.68
| Facility | | $316.23 | $6,918.31 | $22,908.68 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $162.18 / $2,344.23 / $5,888.44
| Professional | | $162.18 | $2,344.23 | $5,888.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12,302.69 / $15,488.17 / $31,622.78
| Facility | | $12,302.69 | $15,488.17 | $31,622.78 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $14,791.08 / $18,620.87 / $31,622.78
| Facility | 50 | $14,791.08 | $18,620.87 | $31,622.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $269.15 / $3,090.30 / $6,309.57
| Professional | | $269.15 | $3,090.30 | $6,309.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10,000.00 / $10,000.00 / $10,000.00
| Facility | | $10,000.00 | $10,000.00 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $257.04 / $549.54 / $7,585.78
| Professional | | $257.04 | $549.54 | $7,585.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $263.03 / $4,677.35 / $10,000.00
| Facility | | $263.03 | $4,677.35 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $14,454.40 / $23,988.33 / $41,686.94
| Facility | 50 | $14,454.40 | $23,988.33 | $41,686.94 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $263.03 / $3,630.78 / $7,762.47
| Professional | | $263.03 | $3,630.78 | $7,762.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $32.36 / $33.11
| Professional | | $32.36 | $32.36 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,818.38 / $4,677.35 / $4,677.35
| Facility | | $2,818.38 | $4,677.35 | $4,677.35 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,388.44 / $3,630.78 / $3,630.78
| Facility | | $3,388.44 | $3,630.78 | $3,630.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $229.09 / $3,388.44 / $6,456.54
| Professional | | $229.09 | $3,388.44 | $6,456.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11,748.98 / $16,218.10 / $31,622.78
| Facility | | $11,748.98 | $16,218.10 | $31,622.78 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $14,791.08 / $17,782.79 / $31,622.78
| Facility | 50 | $14,791.08 | $17,782.79 | $31,622.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $269.15 / $3,090.30 / $6,309.57
| Professional | | $269.15 | $3,090.30 | $6,309.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,011.87 / $18,197.01 / $33,884.42
| Facility | | $5,011.87 | $18,197.01 | $33,884.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $229.09 / $2,398.83 / $6,918.31
| Professional | | $229.09 | $2,398.83 | $6,918.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $158.49 / $295.12 / $3,548.13
| Professional | | $158.49 | $295.12 | $3,548.13 |