- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $245.47 / $3,388.44 / $4,897.79
| Facility | | $245.47 | $3,388.44 | $4,897.79 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $1,445.44 / $3,981.07 / $14,791.08
| Facility | 50 | $1,445.44 | $3,981.07 | $14,791.08 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $177.83 / $1,445.44 / $3,388.44
| Professional | | $177.83 | $1,445.44 | $3,388.44 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $107.15 / $194.98 / $7,585.78
| Professional | 50 | $107.15 | $194.98 | $7,585.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $45.71 / $407.38 / $407.38
| Facility | | $45.71 | $407.38 | $407.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $53.70 / $288.40 / $501.19
| Professional | | $53.70 | $288.40 | $501.19 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $436.52 / $436.52 / $3,801.89
| Professional | 50 | $436.52 | $436.52 | $3,801.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $181.97 / $1,148.15 / $2,754.23
| Professional | | $181.97 | $1,148.15 | $2,754.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $245.47 / $4,073.80 / $6,165.95
| Facility | | $245.47 | $4,073.80 | $6,165.95 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $1,445.44 / $3,981.07 / $14,791.08
| Facility | 50 | $1,445.44 | $3,981.07 | $14,791.08 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $194.98 / $1,995.26 / $3,801.89
| Professional | | $194.98 | $1,995.26 | $3,801.89 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $107.15 / $107.15 / $7,585.78
| Professional | 50 | $107.15 | $107.15 | $7,585.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $165.96 / $1,148.15 / $2,754.23
| Professional | | $165.96 | $1,148.15 | $2,754.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,786.30 / $7,244.36 / $15,135.61
| Facility | | $4,786.30 | $7,244.36 | $15,135.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $223.87 / $1,778.28 / $4,786.30
| Professional | | $223.87 | $1,778.28 | $4,786.30 |