- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $354.81 / $3,019.95 / $17,782.79
| Facility | | $354.81 | $3,019.95 | $17,782.79 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $10,715.19 / $10,715.19 / $13,182.57
| Facility | 50 | $10,715.19 | $10,715.19 | $13,182.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $173.78 / $478.63 / $1,288.25
| Professional | | $173.78 | $478.63 | $1,288.25 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $2,818.38 / $2,884.03 / $2,884.03
| Professional | 50 | $2,818.38 | $2,884.03 | $2,884.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,760.83 / $10,000.00 / $20,417.38
| Facility | | $6,760.83 | $10,000.00 | $20,417.38 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $10,000.00 / $15,135.61 / $30,199.52
| Facility | 50 | $10,000.00 | $15,135.61 | $30,199.52 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $288.40 / $630.96 / $1,258.93
| Professional | | $288.40 | $630.96 | $1,258.93 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,801.89 / $3,801.89 / $3,801.89
| Facility | | $3,801.89 | $3,801.89 | $3,801.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $275.42 / $588.84 / $1,479.11
| Professional | | $275.42 | $588.84 | $1,479.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $281.84 / $776.25 / $3,981.07
| Facility | | $281.84 | $776.25 | $3,981.07 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $8,912.51 / $12,302.69 / $26,302.68
| Facility | 50 | $8,912.51 | $12,302.69 | $26,302.68 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $281.84 / $645.65 / $1,698.24
| Professional | | $281.84 | $645.65 | $1,698.24 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $79.43
| Professional | | $32.36 | $33.11 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $812.83 / $1,000.00 / $1,047.13
| Facility | | $812.83 | $1,000.00 | $1,047.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $724.44 / $724.44 / $724.44
| Facility | | $724.44 | $724.44 | $724.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $245.47 / $724.44 / $1,318.26
| Professional | | $245.47 | $724.44 | $1,318.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,918.31 / $10,471.29 / $20,417.38
| Facility | | $6,918.31 | $10,471.29 | $20,417.38 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $10,232.93 / $15,488.17 / $30,199.52
| Facility | 50 | $10,232.93 | $15,488.17 | $30,199.52 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $288.40 / $630.96 / $1,258.93
| Professional | | $288.40 | $630.96 | $1,258.93 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,691.53 / $11,481.54 / $21,379.62
| Facility | | $2,691.53 | $11,481.54 | $21,379.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $239.88 / $549.54 / $1,288.25
| Professional | | $239.88 | $549.54 | $1,288.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $165.96 / $316.23 / $741.31
| Professional | | $165.96 | $316.23 | $741.31 |