- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $478.63 / $7,943.28 / $20,892.96
| Facility | | $478.63 | $7,943.28 | $20,892.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $245.47 / $1,412.54 / $6,025.60
| Professional | | $245.47 | $1,412.54 | $6,025.60 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $5,623.41 / $5,888.44 / $5,888.44
| Professional | 50 | $5,623.41 | $5,888.44 | $5,888.44 |
- 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
- $407.38 / $2,238.72 / $8,128.31
| Professional | | $407.38 | $2,238.72 | $8,128.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,466.84 / $4,466.84 / $7,413.10
| Facility | | $4,466.84 | $4,466.84 | $7,413.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $346.74 / $831.76 / $9,332.54
| Professional | | $346.74 | $831.76 | $9,332.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $398.11 / $4,786.30 / $10,000.00
| Facility | | $398.11 | $4,786.30 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $16,982.44 / $24,547.09 / $48,977.88
| Facility | 50 | $16,982.44 | $24,547.09 | $48,977.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $398.11 / $3,981.07 / $8,511.38
| Professional | | $398.11 | $3,981.07 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $56.23
| Professional | | $32.36 | $33.11 | $56.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,467.37 / $5,888.44 / $6,918.31
| Facility | | $3,467.37 | $5,888.44 | $6,918.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,265.80 / $4,265.80 / $4,466.84
| Facility | | $4,265.80 | $4,265.80 | $4,466.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $346.74 / $4,265.80 / $7,943.28
| Professional | | $346.74 | $4,265.80 | $7,943.28 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12,882.50 / $19,054.61 / $37,153.52
| Facility | | $12,882.50 | $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
- $407.38 / $2,238.72 / $7,943.28
| Professional | | $407.38 | $2,238.72 | $7,943.28 |
- 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
- $338.84 / $2,951.21 / $8,128.31
| Professional | | $338.84 | $2,951.21 | $8,128.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $229.09 / $436.52 / $4,365.16
| Professional | | $229.09 | $436.52 | $4,365.16 |