- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $380.19 / $4,677.35 / $18,620.87
| Facility | | $380.19 | $4,677.35 | $18,620.87 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $17,378.01 / $17,378.01 / $17,378.01
| Facility | 50 | $17,378.01 | $17,378.01 | $17,378.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $181.97 / $954.99 / $4,786.30
| Professional | | $181.97 | $954.99 | $4,786.30 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $912.01 / $933.25 / $1,412.54
| Professional | 50 | $912.01 | $933.25 | $1,412.54 |
- 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
- $295.12 / $1,862.09 / $4,365.16
| Professional | | $295.12 | $1,862.09 | $4,365.16 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,041.74 / $2,041.74 / $3,388.44
| Facility | | $2,041.74 | $2,041.74 | $3,388.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $275.42 / $562.34 / $5,128.61
| Professional | | $275.42 | $562.34 | $5,128.61 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $295.12 / $2,884.03 / $5,888.44
| Facility | | $295.12 | $2,884.03 | $5,888.44 |
- 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
- $295.12 / $2,290.87 / $4,677.35
| Professional | | $295.12 | $2,290.87 | $4,677.35 |
- 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
- $2,630.27 / $3,162.28 / $3,981.07
| Facility | | $2,630.27 | $3,162.28 | $3,981.07 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,290.87 / $2,290.87 / $2,398.83
| Facility | | $2,290.87 | $2,290.87 | $2,398.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $245.47 / $2,290.87 / $4,265.80
| Professional | | $245.47 | $2,290.87 | $4,265.80 |
- 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
- $302.00 / $1,862.09 / $4,365.16
| Professional | | $302.00 | $1,862.09 | $4,365.16 |
- 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
- $251.19 / $1,584.89 / $5,495.41
| Professional | | $251.19 | $1,584.89 | $5,495.41 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $162.18 / $309.03 / $2,344.23
| Professional | | $162.18 | $309.03 | $2,344.23 |