- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $489.78 / $3,981.07 / $11,481.54
| Facility | | $489.78 | $3,981.07 | $11,481.54 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $204.17 / $4,570.88 / $8,709.64
| Facility | 50 | $204.17 | $4,570.88 | $8,709.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $323.59 / $426.58 / $1,047.13
| Professional | | $323.59 | $426.58 | $1,047.13 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $263.03 / $630.96 / $2,511.89
| Professional | 50 | $263.03 | $630.96 | $2,511.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,677.35 / $9,772.37 / $18,620.87
| Facility | | $4,677.35 | $9,772.37 | $18,620.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $269.15 / $338.84 / $1,047.13
| Professional | | $269.15 | $338.84 | $1,047.13 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $398.11 / $512.86 / $1,548.82
| Professional | 50 | $398.11 | $512.86 | $1,548.82 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $457.09 / $2,630.27 / $12,302.69
| Facility | | $457.09 | $2,630.27 | $12,302.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $457.09 / $457.09 / $457.09
| Professional | | $457.09 | $457.09 | $457.09 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14,791.08 / $17,378.01 / $20,892.96
| Facility | | $14,791.08 | $17,378.01 | $20,892.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $316.23 / $691.83 / $1,548.82
| Professional | | $316.23 | $691.83 | $1,548.82 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $316.23 / $537.03 / $1,995.26
| Facility | | $316.23 | $537.03 | $1,995.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $288.40 / $389.05 / $588.84
| Professional | | $288.40 | $389.05 | $588.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $288.40 / $398.11 / $676.08
| Professional | | $288.40 | $398.11 | $676.08 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7,079.46 / $7,079.46 / $7,943.28
| Facility | | $7,079.46 | $7,079.46 | $7,943.28 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $1,698.24 / $11,748.98 / $13,489.63
| Facility | 50 | $1,698.24 | $11,748.98 | $13,489.63 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $436.52 / $50,118.72 / $75,857.76
| Facility | | $436.52 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $380.19 / $426.58 / $691.83
| Professional | | $380.19 | $426.58 | $691.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,344.23 / $4,897.79 / $11,481.54
| Facility | | $2,344.23 | $4,897.79 | $11,481.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $263.03 / $457.09 / $1,258.93
| Professional | | $263.03 | $457.09 | $1,258.93 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $263.03 / $346.74 / $1,513.56
| Facility | | $263.03 | $346.74 | $1,513.56 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $263.03 / $389.05 / $1,047.13
| Professional | | $263.03 | $389.05 | $1,047.13 |