- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $354.81 / $3,801.89 / $13,182.57
| Facility | | $354.81 | $3,801.89 | $13,182.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $181.97 / $562.34 / $4,168.69
| Professional | | $181.97 | $562.34 | $4,168.69 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $912.01 / $1,348.96 / $5,888.44
| Professional | 50 | $912.01 | $1,348.96 | $5,888.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $275.42 / $588.84 / $4,897.79
| Professional | | $275.42 | $588.84 | $4,897.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $288.40 / $1,584.89 / $4,073.80
| Professional | | $288.40 | $1,584.89 | $4,073.80 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $239.88 / $1,905.46 / $5,754.40
| Facility | | $239.88 | $1,905.46 | $5,754.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $263.03 / $1,659.59 / $4,265.80
| Professional | | $263.03 | $1,659.59 | $4,265.80 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $912.01 / $1,348.96 / $5,888.44
| Professional | 50 | $912.01 | $1,348.96 | $5,888.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,187.76 / $3,162.28 / $3,890.45
| Facility | | $2,187.76 | $3,162.28 | $3,890.45 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $229.09 / $1,778.28 / $5,248.07
| Facility | | $229.09 | $1,778.28 | $5,248.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $79.43 / $478.63 / $4,570.88
| Professional | | $79.43 | $478.63 | $4,570.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15,135.61 / $21,379.62 / $26,915.35
| Facility | | $15,135.61 | $21,379.62 | $26,915.35 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $22,908.68 / $32,359.37 / $39,810.72
| Facility | 50 | $22,908.68 | $32,359.37 | $39,810.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $354.81 / $616.60 / $4,570.88
| Professional | | $354.81 | $616.60 | $4,570.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,073.80 / $20,892.96 / $30,902.95
| Facility | | $4,073.80 | $20,892.96 | $30,902.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $281.84 / $1,479.11 / $5,128.61
| Professional | | $281.84 | $1,479.11 | $5,128.61 |