- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $524.81 / $5,011.87 / $8,511.38
| Facility | | $524.81 | $5,011.87 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $3,715.35 / $3,715.35 / $8,912.51
| Facility | 50 | $3,715.35 | $3,715.35 | $8,912.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $186.21 / $446.68 / $912.01
| Professional | | $186.21 | $446.68 | $912.01 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $602.56 / $602.56 / $1,905.46
| Professional | 50 | $602.56 | $602.56 | $1,905.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $138.04 / $245.47 / $562.34
| Professional | | $138.04 | $245.47 | $562.34 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,495.41 / $7,244.36 / $14,125.38
| Facility | | $5,495.41 | $7,244.36 | $14,125.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $190.55 / $302.00 / $478.63
| Professional | | $190.55 | $302.00 | $478.63 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $239.88 / $478.63 / $758.58
| Professional | | $239.88 | $478.63 | $758.58 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $229.09 / $446.68 / $3,715.35
| Facility | | $229.09 | $446.68 | $3,715.35 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $323.59 / $537.03 / $2,187.76
| Professional | | $323.59 | $537.03 | $2,187.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $363.08 / $562.34 / $724.44
| Professional | | $363.08 | $562.34 | $724.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $363.08 / $363.08 / $562.34
| Professional | | $363.08 | $363.08 | $562.34 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $446.68 / $776.25
| Professional | | $5.01 | $446.68 | $776.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,187.76 / $2,691.53 / $6,760.83
| Facility | | $2,187.76 | $2,691.53 | $6,760.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $218.78 / $363.08 / $588.84
| Professional | | $218.78 | $363.08 | $588.84 |