- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $346.74 / $4,570.88 / $15,135.61
| Facility | | $346.74 | $4,570.88 | $15,135.61 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $0.56 / $1,862.09 / $8,709.64
| Facility | 50 | $0.56 | $1,862.09 | $8,709.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $234.42 / $416.87 / $758.58
| Professional | | $234.42 | $416.87 | $758.58 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $131.83 / $426.58 / $851.14
| Professional | 50 | $131.83 | $426.58 | $851.14 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $102.33 / $114.82 / $125.89
| Professional | | $102.33 | $114.82 | $125.89 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $144.54 / $169.82 / $295.12
| Professional | 50 | $144.54 | $169.82 | $295.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $891.25 / $4,466.84 / $12,302.69
| Facility | | $891.25 | $4,466.84 | $12,302.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $223.87 / $309.03 / $478.63
| Professional | | $223.87 | $309.03 | $478.63 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,398.83 / $16,595.87 / $53,703.18
| Facility | | $2,398.83 | $16,595.87 | $53,703.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $239.88 / $398.11 / $776.25
| Professional | | $239.88 | $398.11 | $776.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,456.54 / $13,489.63 / $23,988.33
| Facility | | $6,456.54 | $13,489.63 | $23,988.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $275.42 / $316.23 / $416.87
| Professional | | $275.42 | $316.23 | $416.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $501.19
| Professional | | $32.36 | $33.11 | $501.19 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,737.80 / $5,888.44 / $10,000.00
| Facility | | $1,737.80 | $5,888.44 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $223.87 / $371.54 / $707.95
| Professional | | $223.87 | $371.54 | $707.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $186.21 / $309.03 / $457.09
| Professional | | $186.21 | $309.03 | $457.09 |