- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $660.69 / $2,344.23 / $7,079.46
| Facility | | $660.69 | $2,344.23 | $7,079.46 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $1,479.11 / $2,884.03 / $6,309.57
| Facility | 50 | $1,479.11 | $2,884.03 | $6,309.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $100.00 / $186.21 / $398.11
| Professional | | $100.00 | $186.21 | $398.11 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $85.11 / $177.83 / $323.59
| Professional | 50 | $85.11 | $177.83 | $323.59 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $69.18 / $138.04 / $151.36
| Professional | | $69.18 | $138.04 | $151.36 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $204.17 / $208.93 / $208.93
| Professional | 50 | $204.17 | $208.93 | $208.93 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,000.00 / $2,570.40 / $5,888.44
| Facility | | $1,000.00 | $2,570.40 | $5,888.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $158.49 / $245.47 / $323.59
| Professional | | $158.49 | $245.47 | $323.59 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $239.88 / $371.54 / $478.63
| Professional | 50 | $239.88 | $371.54 | $478.63 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,000.00 / $1,000.00 / $1,000.00
| Facility | | $1,000.00 | $1,000.00 | $1,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $162.18 / $257.04 / $416.87
| Professional | | $162.18 | $257.04 | $416.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $141.25 / $173.78 / $524.81
| Professional | | $141.25 | $173.78 | $524.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $204.17 / $257.04 / $346.74
| Professional | | $204.17 | $257.04 | $346.74 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,202.26 / $3,630.78 / $6,309.57
| Facility | | $1,202.26 | $3,630.78 | $6,309.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $154.88 / $213.80 / $389.05
| Professional | | $154.88 | $213.80 | $389.05 |