- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,258.93 / $2,511.89 / $16,595.87
| Facility | | $1,258.93 | $2,511.89 | $16,595.87 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $6,309.57 / $6,309.57 / $6,309.57
| Facility | 50 | $6,309.57 | $6,309.57 | $6,309.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $239.88 / $416.87 / $794.33
| Professional | | $239.88 | $416.87 | $794.33 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $354.81 / $549.54 / $1,071.52
| Professional | 50 | $354.81 | $549.54 | $1,071.52 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $302.00 / $380.19 / $831.76
| Professional | | $302.00 | $380.19 | $831.76 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $275.42 / $660.69 / $2,818.38
| Facility | | $275.42 | $660.69 | $2,818.38 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $6,309.57 / $6,309.57 / $6,309.57
| Facility | 50 | $6,309.57 | $6,309.57 | $6,309.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $426.58 / $1,096.48 / $2,818.38
| Professional | | $426.58 | $1,096.48 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $354.81 / $549.54 / $1,071.52
| Professional | 50 | $354.81 | $549.54 | $1,071.52 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $977.24 / $1,778.28 / $2,290.87
| Professional | | $977.24 | $1,778.28 | $2,290.87 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $275.42 / $562.34 / $1,995.26
| Facility | | $275.42 | $562.34 | $1,995.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $60.26 / $537.03 / $977.24
| Professional | | $60.26 | $537.03 | $977.24 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14,454.40 / $14,454.40 / $14,454.40
| Facility | | $14,454.40 | $14,454.40 | $14,454.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $371.54 / $1,000.00 / $2,344.23
| Professional | | $371.54 | $1,000.00 | $2,344.23 |