- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $53.70 / $354.81 / $5,623.41
| Facility | | $53.70 | $354.81 | $5,623.41 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $954.99 / $954.99 / $954.99
| Facility | 50 | $954.99 | $954.99 | $954.99 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $48.98 / $151.36 / $457.09
| Professional | | $48.98 | $151.36 | $457.09 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $218.78 / $229.09 / $912.01
| Professional | 50 | $218.78 | $229.09 | $912.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $38.02 / $51.29 / $52.48
| Professional | | $38.02 | $51.29 | $52.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $95.50 / $95.50 / $181.97
| Facility | | $95.50 | $95.50 | $181.97 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $53.70 / $269.15 / $616.60
| Professional | | $53.70 | $269.15 | $616.60 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $79.43 / $407.38 / $933.25
| Professional | 50 | $79.43 | $407.38 | $933.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $44.67 / $46.77 / $52.48
| Facility | | $44.67 | $46.77 | $52.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $51.29 / $75.86 / $741.31
| Facility | | $51.29 | $75.86 | $741.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $52.48 / $234.42 / $524.81
| Professional | | $52.48 | $234.42 | $524.81 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $426.58 / $2,290.87 / $7,413.10
| Facility | | $426.58 | $2,290.87 | $7,413.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $47.86 / $251.19 / $478.63
| Professional | | $47.86 | $251.19 | $478.63 |