- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $263.03 / $4,168.69 / $10,964.78
| Facility | | $263.03 | $4,168.69 | $10,964.78 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $2,630.27 / $2,754.23 / $3,235.94
| Facility | 50 | $2,630.27 | $2,754.23 | $3,235.94 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $154.88 / $1,548.82 / $3,715.35
| Professional | | $154.88 | $1,548.82 | $3,715.35 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $3,388.44 / $3,548.13 / $4,786.30
| Professional | 50 | $3,388.44 | $3,548.13 | $4,786.30 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $954.99 / $954.99 / $954.99
| Professional | 50 | $954.99 | $954.99 | $954.99 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,949.84 / $4,677.35 / $15,135.61
| Facility | | $1,949.84 | $4,677.35 | $15,135.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $181.97 / $1,230.27 / $3,311.31
| Professional | | $181.97 | $1,230.27 | $3,311.31 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $275.42 / $1,862.09 / $4,897.79
| Professional | 50 | $275.42 | $1,862.09 | $4,897.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $147.91 / $158.49 / $177.83
| Facility | | $147.91 | $158.49 | $177.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $21,379.62 / $21,379.62 / $21,379.62
| Facility | | $21,379.62 | $21,379.62 | $21,379.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $177.83 / $407.38 / $3,090.30
| Professional | | $177.83 | $407.38 | $3,090.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $323.59 / $537.03 / $21,379.62
| Facility | | $323.59 | $537.03 | $21,379.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $181.97 / $457.09 / $3,235.94
| Professional | | $181.97 | $457.09 | $3,235.94 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $33.11
| Professional | | $32.36 | $33.11 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $100.00 / $100.00 / $8,709.64
| Facility | | $100.00 | $100.00 | $8,709.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $138.04 / $1,513.56 / $2,884.03
| Professional | | $138.04 | $1,513.56 | $2,884.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,548.13 / $5,754.40 / $10,471.29
| Facility | | $3,548.13 | $5,754.40 | $10,471.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $154.88 / $1,258.93 / $3,019.95
| Professional | | $154.88 | $1,258.93 | $3,019.95 |