- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $812.83 / $3,388.44 / $12,022.64
| Facility | | $812.83 | $3,388.44 | $12,022.64 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $616.60 / $3,548.13 / $5,011.87
| Facility | 50 | $616.60 | $3,548.13 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $141.25 / $1,513.56 / $3,235.94
| Professional | | $141.25 | $1,513.56 | $3,235.94 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $389.05 / $1,862.09 / $7,244.36
| Professional | 50 | $389.05 | $1,862.09 | $7,244.36 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,698.24 / $2,754.23 / $11,220.18
| Facility | | $1,698.24 | $2,754.23 | $11,220.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $138.04 / $1,348.96 / $2,290.87
| Professional | | $138.04 | $1,348.96 | $2,290.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,089.30 / $2,089.30 / $2,089.30
| Professional | | $2,089.30 | $2,089.30 | $2,089.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $120.23 / $7,762.47 / $7,762.47
| Facility | | $120.23 | $7,762.47 | $7,762.47 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,041.74 / $2,041.74 / $2,041.74
| Facility | | $2,041.74 | $2,041.74 | $2,041.74 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $162.18 / $457.09 / $4,073.80
| Professional | | $162.18 | $457.09 | $4,073.80 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $54.95 / $56.23 / $17,378.01
| Facility | | $54.95 | $56.23 | $17,378.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19,498.45 / $19,498.45 / $19,498.45
| Professional | | $19,498.45 | $19,498.45 | $19,498.45 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $158.49 / $1,819.70 / $5,128.61
| Facility | | $158.49 | $1,819.70 | $5,128.61 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $616.60 / $3,548.13 / $5,011.87
| Facility | 50 | $616.60 | $3,548.13 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $151.36 / $1,513.56 / $2,951.21
| Professional | | $151.36 | $1,513.56 | $2,951.21 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $389.05 / $1,862.09 / $7,244.36
| Professional | 50 | $389.05 | $1,862.09 | $7,244.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $120.23
| Professional | | $32.36 | $33.11 | $120.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $4,677.35 / $5,370.32
| Professional | | $5.01 | $4,677.35 | $5,370.32 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $141.25 / $1,318.26 / $4,168.69
| Facility | | $141.25 | $1,318.26 | $4,168.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $158.49 / $446.68 / $3,981.07
| Professional | | $158.49 | $446.68 | $3,981.07 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,445.44 / $4,265.80 / $7,585.78
| Facility | | $1,445.44 | $4,265.80 | $7,585.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $138.04 / $1,148.15 / $3,981.07
| Professional | | $138.04 | $1,148.15 | $3,981.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,479.11 / $1,548.82 / $1,548.82
| Professional | | $1,479.11 | $1,548.82 | $1,548.82 |