- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $467.74 / $3,981.07 / $10,232.93
| Facility | | $467.74 | $3,981.07 | $10,232.93 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $3,235.94 / $4,365.16 / $6,918.31
| Facility | 50 | $3,235.94 | $4,365.16 | $6,918.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $239.88 / $467.74 / $1,288.25
| Professional | | $239.88 | $467.74 | $1,288.25 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $169.82 / $1,230.27 / $1,862.09
| Professional | 50 | $169.82 | $1,230.27 | $1,862.09 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,165.95 / $9,549.93 / $13,489.63
| Facility | | $6,165.95 | $9,549.93 | $13,489.63 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $281.84 / $416.87 / $724.44
| Professional | | $281.84 | $416.87 | $724.44 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $489.78 / $575.44 / $630.96
| Professional | 50 | $489.78 | $575.44 | $630.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,570.40 / $2,570.40 / $2,570.40
| Facility | | $2,570.40 | $2,570.40 | $2,570.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $257.04 / $380.19 / $676.08
| Professional | | $257.04 | $380.19 | $676.08 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.79 / $338.84 / $724.44
| Professional | | $4.79 | $338.84 | $724.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,570.40 / $2,570.40 / $2,570.40
| Facility | | $2,570.40 | $2,570.40 | $2,570.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.07 / $302.00 / $645.65
| Professional | | $4.07 | $302.00 | $645.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $204.17 / $436.52 / $436.52
| Professional | | $204.17 | $436.52 | $436.52 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,288.25 / $2,344.23 / $7,413.10
| Facility | | $1,288.25 | $2,344.23 | $7,413.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $234.42 / $398.11 / $851.14
| Professional | | $234.42 | $398.11 | $851.14 |