- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $251.19 / $1,584.89 / $6,918.31
| Facility | | $251.19 | $1,584.89 | $6,918.31 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $0.50 / $3,090.30 / $15,848.93
| Facility | 50 | $0.50 | $3,090.30 | $15,848.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $165.96 / $478.63 / $1,380.38
| Professional | | $165.96 | $478.63 | $1,380.38 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $123.03 / $1,230.27 / $4,168.69
| Professional | 50 | $123.03 | $1,230.27 | $4,168.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $67.61 / $218.78 / $741.31
| Professional | | $67.61 | $218.78 | $741.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $831.76 / $6,025.60 / $12,302.69
| Facility | | $831.76 | $6,025.60 | $12,302.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $177.83 / $660.69 / $912.01
| Professional | | $177.83 | $660.69 | $912.01 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $295.12 / $295.12 / $295.12
| Facility | | $295.12 | $295.12 | $295.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $165.96 / $575.44 / $1,445.44
| Professional | | $165.96 | $575.44 | $1,445.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $51.29 / $53.70 / $58.88
| Facility | | $51.29 | $53.70 | $58.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $549.54 / $588.84 / $812.83
| Professional | | $549.54 | $588.84 | $812.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $489.78
| Professional | | $32.36 | $33.11 | $489.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $295.12 / $1,548.82 / $3,890.45
| Facility | | $295.12 | $1,548.82 | $3,890.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $165.96 / $630.96 / $1,479.11
| Professional | | $165.96 | $630.96 | $1,479.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $131.83 / $281.84 / $831.76
| Professional | | $131.83 | $281.84 | $831.76 |