- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,412.54 / $4,466.84 / $7,079.46
| Facility | | $1,412.54 | $4,466.84 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $107.15 / $371.54 / $1,047.13
| Professional | | $107.15 | $371.54 | $1,047.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $602.56 / $1,288.25 / $1,949.84
| Facility | | $602.56 | $1,288.25 | $1,949.84 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $954.99 / $1,905.46 / $3,090.30
| Facility | 50 | $954.99 | $1,905.46 | $3,090.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $177.83 / $776.25 / $1,000.00
| Professional | | $177.83 | $776.25 | $1,000.00 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $295.12 / $1,202.26 / $1,445.44
| Professional | 50 | $295.12 | $1,202.26 | $1,445.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $131.83 / $512.86 / $1,000.00
| Professional | | $131.83 | $512.86 | $1,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $776.25 / $776.25 / $1,148.15
| Professional | | $776.25 | $776.25 | $1,148.15 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $128.82 / $512.86 / $1,288.25
| Facility | | $128.82 | $512.86 | $1,288.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $144.54 / $575.44 / $1,288.25
| Professional | | $144.54 | $575.44 | $1,288.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $204.17 / $331.13
| Professional | | $32.36 | $204.17 | $331.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $194.98 / $263.03 / $1,122.02
| Professional | | $194.98 | $263.03 | $1,122.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $194.98 / $467.74 / $1,096.48
| Professional | | $194.98 | $467.74 | $1,096.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,819.70 / $8,317.64 / $9,332.54
| Facility | | $1,819.70 | $8,317.64 | $9,332.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $120.23 / $288.40 / $977.24
| Professional | | $120.23 | $288.40 | $977.24 |