- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $181.97 / $1,905.46 / $3,235.94
| Facility | | $181.97 | $1,905.46 | $3,235.94 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $6,606.93 / $6,606.93 / $6,606.93
| Facility | 50 | $6,606.93 | $6,606.93 | $6,606.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $181.97 / $954.99 / $3,801.89
| Professional | | $181.97 | $954.99 | $3,801.89 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $123.03 / $912.01 / $1,412.54
| Professional | 50 | $123.03 | $912.01 | $1,412.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,819.70 / $12,882.50 / $31,622.78
| Facility | | $1,819.70 | $12,882.50 | $31,622.78 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $16,218.10 / $26,302.68 / $74,131.02
| Facility | 50 | $16,218.10 | $26,302.68 | $74,131.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $323.59 / $1,148.15 / $5,754.40
| Professional | | $323.59 | $1,148.15 | $5,754.40 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $489.78 / $1,698.24 / $8,709.64
| Professional | 50 | $489.78 | $1,698.24 | $8,709.64 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,365.16 / $6,456.54 / $15,135.61
| Facility | | $4,365.16 | $6,456.54 | $15,135.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $389.05 / $2,818.38 / $6,918.31
| Professional | | $389.05 | $2,818.38 | $6,918.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,677.35 / $5,888.44 / $11,481.54
| Facility | | $4,677.35 | $5,888.44 | $11,481.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $380.19 / $1,202.26 / $6,165.95
| Professional | | $380.19 | $1,202.26 | $6,165.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $239.88 / $2,454.71 / $9,332.54
| Facility | | $239.88 | $2,454.71 | $9,332.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,344.23 / $4,677.35 / $10,964.78
| Professional | | $2,344.23 | $4,677.35 | $10,964.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,584.89 / $6,760.83 / $18,197.01
| Facility | | $1,584.89 | $6,760.83 | $18,197.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $275.42 / $1,819.70 / $6,309.57
| Professional | | $275.42 | $1,819.70 | $6,309.57 |