- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $501.19 / $7,244.36 / $13,803.84
| Facility | | $501.19 | $7,244.36 | $13,803.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $234.42 / $1,348.96 / $7,079.46
| Professional | | $234.42 | $1,348.96 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $5,623.41 / $5,623.41 / $5,623.41
| Professional | 50 | $5,623.41 | $5,623.41 | $5,623.41 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $363.08 / $2,754.23 / $8,912.51
| Professional | | $363.08 | $2,754.23 | $8,912.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $407.38 / $2,951.21 / $7,413.10
| Professional | | $407.38 | $2,951.21 | $7,413.10 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $316.23 / $3,235.94 / $8,128.31
| Facility | | $316.23 | $3,235.94 | $8,128.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $363.08 / $3,235.94 / $8,317.64
| Professional | | $363.08 | $3,235.94 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $5,623.41 / $5,623.41 / $5,623.41
| Professional | 50 | $5,623.41 | $5,623.41 | $5,623.41 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,073.80 / $5,888.44 / $6,918.31
| Facility | | $4,073.80 | $5,888.44 | $6,918.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $309.03 / $3,235.94 / $8,128.31
| Facility | | $309.03 | $3,235.94 | $8,128.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $79.43 / $707.95 / $8,511.38
| Professional | | $79.43 | $707.95 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15,488.17 / $21,379.62 / $26,915.35
| Facility | | $15,488.17 | $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
- $489.78 / $870.96 / $8,511.38
| Professional | | $489.78 | $870.96 | $8,511.38 |
- 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
- $389.05 / $2,754.23 / $8,511.38
| Professional | | $389.05 | $2,754.23 | $8,511.38 |