- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $57.54 / $501.19 / $1,096.48
| Facility | | $57.54 | $501.19 | $1,096.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $48.98 / $234.42 / $602.56
| Professional | | $48.98 | $234.42 | $602.56 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $67.61 / $239.88 / $912.01
| Professional | 50 | $67.61 | $239.88 | $912.01 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,202.26 / $1,584.89 / $1,584.89
| Facility | | $1,202.26 | $1,584.89 | $1,584.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $72.44 / $309.03 / $1,096.48
| Professional | | $72.44 | $309.03 | $1,096.48 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $109.65 / $457.09 / $1,621.81
| Professional | 50 | $109.65 | $457.09 | $1,621.81 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $676.08 / $794.33 / $1,258.93
| Facility | | $676.08 | $794.33 | $1,258.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $69.18 / $186.21 / $912.01
| Professional | | $69.18 | $186.21 | $912.01 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $54.95 / $295.12 / $3,090.30
| Facility | | $54.95 | $295.12 | $3,090.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $89.13 / $158.49 / $724.44
| Professional | | $89.13 | $158.49 | $724.44 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $131.83 / $239.88 / $1,071.52
| Professional | 50 | $131.83 | $239.88 | $1,071.52 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $53.70 / $309.03 / $1,513.56
| Facility | | $53.70 | $309.03 | $1,513.56 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $331.13 / $870.96 / $2,290.87
| Professional | | $331.13 | $870.96 | $2,290.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $85.11
| Professional | | $32.36 | $33.11 | $85.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $95.50 / $891.25 / $2,344.23
| Facility | | $95.50 | $891.25 | $2,344.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $109.65 / $407.38 / $1,000.00
| Professional | | $109.65 | $407.38 | $1,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $77.62 / $263.03 / $831.76
| Professional | | $77.62 | $263.03 | $831.76 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $316.23 / $8,709.64 / $8,709.64
| Facility | | $316.23 | $8,709.64 | $8,709.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $79.43 / $933.25 / $2,290.87
| Professional | | $79.43 | $933.25 | $2,290.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $239.88 / $239.88 / $1,412.54
| Professional | | $239.88 | $239.88 | $1,412.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $239.88 / $354.81 / $1,737.80
| Professional | | $239.88 | $354.81 | $1,737.80 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,023.29 / $1,659.59 / $2,187.76
| Facility | | $1,023.29 | $1,659.59 | $2,187.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $79.43 / $223.87 / $389.05
| Professional | | $79.43 | $223.87 | $389.05 |