- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $162.18 / $1,621.81 / $11,481.54
| Facility | | $162.18 | $1,621.81 | $11,481.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $87.10 / $251.19 / $776.25
| Professional | | $87.10 | $251.19 | $776.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,202.26 / $1,659.59 / $3,388.44
| Facility | | $1,202.26 | $1,659.59 | $3,388.44 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $1,819.70 / $2,511.89 / $5,128.61
| Facility | 50 | $1,819.70 | $2,511.89 | $5,128.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $141.25 / $288.40 / $588.84
| Professional | | $141.25 | $288.40 | $588.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $467.74 / $467.74 / $794.33
| Facility | | $467.74 | $467.74 | $794.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $138.04 / $263.03 / $691.83
| Professional | | $138.04 | $263.03 | $691.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $141.25 / $380.19 / $1,288.25
| Facility | | $141.25 | $380.19 | $1,288.25 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $1,513.56 / $2,630.27 / $4,570.88
| Facility | 50 | $1,513.56 | $2,630.27 | $4,570.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $141.25 / $309.03 / $758.58
| Professional | | $141.25 | $309.03 | $758.58 |
- 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
- $181.97 / $426.58 / $467.74
| Facility | | $181.97 | $426.58 | $467.74 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $323.59 / $323.59 / $323.59
| Facility | | $323.59 | $323.59 | $323.59 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $120.23 / $323.59 / $588.84
| Professional | | $120.23 | $323.59 | $588.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,202.26 / $1,737.80 / $3,388.44
| Facility | | $1,202.26 | $1,737.80 | $3,388.44 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $1,778.28 / $2,630.27 / $5,128.61
| Facility | 50 | $1,778.28 | $2,630.27 | $5,128.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $144.54 / $288.40 / $562.34
| Professional | | $144.54 | $288.40 | $562.34 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $588.84 / $2,137.96 / $4,265.80
| Facility | | $588.84 | $2,137.96 | $4,265.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $120.23 / $263.03 / $794.33
| Professional | | $120.23 | $263.03 | $794.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $83.18 / $158.49 / $380.19
| Professional | | $83.18 | $158.49 | $380.19 |