- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $186.21 / $2,089.30 / $6,456.54
| Facility | | $186.21 | $2,089.30 | $6,456.54 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $4,570.88 / $4,570.88 / $4,570.88
| Facility | 50 | $4,570.88 | $4,570.88 | $4,570.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $154.88 / $1,584.89 / $2,951.21
| Professional | | $154.88 | $1,584.89 | $2,951.21 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $125.89 / $478.63 / $1,737.80
| Professional | 50 | $125.89 | $478.63 | $1,737.80 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9,549.93 / $12,882.50 / $21,877.62
| Facility | | $9,549.93 | $12,882.50 | $21,877.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $251.19 / $1,905.46 / $7,079.46
| Professional | | $251.19 | $1,905.46 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $380.19 / $2,884.03 / $10,715.19
| Professional | 50 | $380.19 | $2,884.03 | $10,715.19 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,570.88 / $5,248.07 / $8,511.38
| Facility | | $4,570.88 | $5,248.07 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $229.09 / $549.54 / $5,754.40
| Professional | | $229.09 | $549.54 | $5,754.40 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $190.55 / $3,311.31 / $5,754.40
| Facility | | $190.55 | $3,311.31 | $5,754.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $331.13 / $512.86 / $4,677.35
| Professional | | $331.13 | $512.86 | $4,677.35 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $501.19 / $776.25 / $7,079.46
| Professional | 50 | $501.19 | $776.25 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- 80
- Typical Low / Median / Typical High
- $53.70 / $83.18 / $758.58
| Professional | 80 | $53.70 | $83.18 | $758.58 |
- Facility/Professional
- Professional
- Modifier
- AS
- Typical Low / Median / Typical High
- $46.77 / $72.44 / $660.69
| Professional | AS | $46.77 | $72.44 | $660.69 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $190.55 / $6,025.60 / $12,589.25
| Facility | | $190.55 | $6,025.60 | $12,589.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,949.84 / $3,715.35 / $8,317.64
| Professional | | $1,949.84 | $3,715.35 | $8,317.64 |
- 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
- $338.84 / $8,511.38 / $9,120.11
| Facility | | $338.84 | $8,511.38 | $9,120.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $389.05 / $2,630.27 / $6,760.83
| Professional | | $389.05 | $2,630.27 | $6,760.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $263.03 / $1,737.80 / $5,495.41
| Professional | | $263.03 | $1,737.80 | $5,495.41 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11,748.98 / $11,748.98 / $17,378.01
| Facility | | $11,748.98 | $11,748.98 | $17,378.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $234.42 / $3,162.28 / $11,220.18
| Professional | | $234.42 | $3,162.28 | $11,220.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $380.19 / $380.19 / $4,265.80
| Professional | | $380.19 | $380.19 | $4,265.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $660.69 / $933.25 / $10,000.00
| Professional | | $660.69 | $933.25 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,606.93 / $10,232.93 / $13,182.57
| Facility | | $6,606.93 | $10,232.93 | $13,182.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $194.98 / $1,513.56 / $7,079.46
| Professional | | $194.98 | $1,513.56 | $7,079.46 |