- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $295.12 / $4,265.80 / $18,620.87
| Facility | | $295.12 | $4,265.80 | $18,620.87 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $10,232.93 / $10,232.93 / $10,232.93
| Facility | 50 | $10,232.93 | $10,232.93 | $10,232.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $158.49 / $1,698.24 / $3,388.44
| Professional | | $158.49 | $1,698.24 | $3,388.44 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $125.89 / $1,548.82 / $2,884.03
| Professional | 50 | $125.89 | $1,548.82 | $2,884.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12,589.25 / $18,197.01 / $37,153.52
| Facility | | $12,589.25 | $18,197.01 | $37,153.52 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $19,054.61 / $27,542.29 / $56,234.13
| Facility | 50 | $19,054.61 | $27,542.29 | $56,234.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $257.04 / $1,862.09 / $4,168.69
| Professional | | $257.04 | $1,862.09 | $4,168.69 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,365.16 / $4,365.16 / $7,244.36
| Facility | | $4,365.16 | $4,365.16 | $7,244.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $245.47 / $512.86 / $4,897.79
| Professional | | $245.47 | $512.86 | $4,897.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $257.04 / $3,162.28 / $7,413.10
| Facility | | $257.04 | $3,162.28 | $7,413.10 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $7,762.47 / $21,877.62 / $48,977.88
| Facility | 50 | $7,762.47 | $21,877.62 | $48,977.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $257.04 / $2,818.38 / $5,248.07
| Professional | | $257.04 | $2,818.38 | $5,248.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $32.36 / $33.11
| Professional | | $32.36 | $32.36 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,862.09 / $3,090.30 / $3,715.35
| Facility | | $1,862.09 | $3,090.30 | $3,715.35 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,238.72 / $2,238.72 / $2,344.23
| Facility | | $2,238.72 | $2,238.72 | $2,344.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $213.80 / $2,238.72 / $4,168.69
| Professional | | $213.80 | $2,238.72 | $4,168.69 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12,589.25 / $19,054.61 / $37,153.52
| Facility | | $12,589.25 | $19,054.61 | $37,153.52 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $19,054.61 / $28,183.83 / $56,234.13
| Facility | 50 | $19,054.61 | $28,183.83 | $56,234.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $263.03 / $1,862.09 / $4,168.69
| Professional | | $263.03 | $1,862.09 | $4,168.69 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,467.37 / $21,877.62 / $39,810.72
| Facility | | $3,467.37 | $21,877.62 | $39,810.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $223.87 / $1,584.89 / $4,265.80
| Professional | | $223.87 | $1,584.89 | $4,265.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $144.54 / $275.42 / $2,344.23
| Professional | | $144.54 | $275.42 | $2,344.23 |