- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $426.58 / $5,248.07 / $11,748.98
| Facility | | $426.58 | $5,248.07 | $11,748.98 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $2,630.27 / $2,630.27 / $5,623.41
| Facility | 50 | $2,630.27 | $2,630.27 | $5,623.41 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $251.19 / $2,884.03 / $5,495.41
| Professional | | $251.19 | $2,884.03 | $5,495.41 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $9,120.11 / $9,120.11 / $9,120.11
| Professional | 50 | $9,120.11 | $9,120.11 | $9,120.11 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $158.49 / $158.49 / $3,630.78
| Professional | 50 | $158.49 | $158.49 | $3,630.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,949.84 / $5,888.44 / $15,135.61
| Facility | | $1,949.84 | $5,888.44 | $15,135.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $257.04 / $2,137.96 / $5,370.32
| Professional | | $257.04 | $2,137.96 | $5,370.32 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $380.19 / $3,235.94 / $7,943.28
| Professional | 50 | $380.19 | $3,235.94 | $7,943.28 |
- Facility/Professional
- Professional
- Modifier
- AS
- Typical Low / Median / Typical High
- $35.48 / $302.00 / $741.31
| Professional | AS | $35.48 | $302.00 | $741.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $239.88 / $257.04 / $288.40
| Facility | | $239.88 | $257.04 | $288.40 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $213.80 / $407.38 / $21,379.62
| Facility | | $213.80 | $407.38 | $21,379.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $275.42 / $724.44 / $5,623.41
| Professional | | $275.42 | $724.44 | $5,623.41 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $21,379.62 / $21,379.62 / $21,379.62
| Facility | | $21,379.62 | $21,379.62 | $21,379.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $275.42 / $831.76 / $5,623.41
| Professional | | $275.42 | $831.76 | $5,623.41 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $190.55
| Professional | | $32.36 | $33.11 | $190.55 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $100.00 / $100.00 / $8,709.64
| Facility | | $100.00 | $100.00 | $8,709.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $223.87 / $660.69 / $5,370.32
| Professional | | $223.87 | $660.69 | $5,370.32 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,548.13 / $5,754.40 / $10,471.29
| Facility | | $3,548.13 | $5,754.40 | $10,471.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $245.47 / $2,398.83 / $5,623.41
| Professional | | $245.47 | $2,398.83 | $5,623.41 |