- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $95.50 / $2,089.30 / $10,232.93
| Facility | | $95.50 | $2,089.30 | $10,232.93 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $251.19 / $5,623.41 / $18,620.87
| Facility | 50 | $251.19 | $5,623.41 | $18,620.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $48.98 / $234.42 / $616.60
| Professional | | $48.98 | $234.42 | $616.60 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $67.61 / $218.78 / $912.01
| Professional | 50 | $67.61 | $218.78 | $912.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $22.91 / $38.02 / $51.29
| Professional | | $22.91 | $38.02 | $51.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $45.71 / $223.87 / $660.69
| Professional | | $45.71 | $223.87 | $660.69 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $69.18 / $338.84 / $1,000.00
| Professional | 50 | $69.18 | $338.84 | $1,000.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $45.71 / $45.71 / $45.71
| Facility | | $45.71 | $45.71 | $45.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $39.81 / $61.66 / $21,379.62
| Facility | | $39.81 | $61.66 | $21,379.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $51.29 / $169.82 / $512.86
| Professional | | $51.29 | $169.82 | $512.86 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $81.28 / $81.28 / $21,379.62
| Facility | | $81.28 | $81.28 | $21,379.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $50.12 / $147.91 / $478.63
| Professional | | $50.12 | $147.91 | $478.63 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $33.11
| Professional | | $32.36 | $33.11 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $43.65 / $239.88 / $524.81
| Professional | | $43.65 | $239.88 | $524.81 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $316.23 / $1,023.29 / $3,235.94
| Facility | | $316.23 | $1,023.29 | $3,235.94 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $50.12 / $229.09 / $501.19
| Professional | | $50.12 | $229.09 | $501.19 |