- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $549.54 / $3,162.28 / $17,782.79
| Facility | | $549.54 | $3,162.28 | $17,782.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $281.84 / $1,122.02 / $2,344.23
| Professional | | $281.84 | $1,122.02 | $2,344.23 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $660.69 / $660.69 / $4,570.88
| Professional | 50 | $660.69 | $660.69 | $4,570.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,456.54 / $8,511.38 / $17,378.01
| Facility | | $6,456.54 | $8,511.38 | $17,378.01 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $9,772.37 / $12,882.50 / $25,703.96
| Facility | 50 | $9,772.37 | $12,882.50 | $25,703.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $457.09 / $912.01 / $2,884.03
| Professional | | $457.09 | $912.01 | $2,884.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $338.84 / $891.25 / $3,388.44
| Professional | | $338.84 | $891.25 | $3,388.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $407.38 / $1,584.89 / $3,388.44
| Facility | | $407.38 | $1,584.89 | $3,388.44 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $8,128.31 / $12,022.64 / $23,442.29
| Facility | 50 | $8,128.31 | $12,022.64 | $23,442.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $363.08 / $954.99 / $3,019.95
| Professional | | $363.08 | $954.99 | $3,019.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $173.78
| Professional | | $32.36 | $33.11 | $173.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,445.44 / $2,344.23 / $2,454.71
| Facility | | $1,445.44 | $2,344.23 | $2,454.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,659.59 / $1,698.24 / $1,698.24
| Facility | | $1,659.59 | $1,698.24 | $1,698.24 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $416.87 / $1,659.59 / $3,019.95
| Professional | | $416.87 | $1,659.59 | $3,019.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,165.95 / $8,912.51 / $17,378.01
| Facility | | $6,165.95 | $8,912.51 | $17,378.01 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $9,332.54 / $13,182.57 / $25,703.96
| Facility | 50 | $9,332.54 | $13,182.57 | $25,703.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $457.09 / $912.01 / $2,818.38
| Professional | | $457.09 | $912.01 | $2,818.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,884.03 / $10,715.19 / $18,197.01
| Facility | | $2,884.03 | $10,715.19 | $18,197.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $363.08 / $1,258.93 / $3,019.95
| Professional | | $363.08 | $1,258.93 | $3,019.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $263.03 / $501.19 / $1,862.09
| Professional | | $263.03 | $501.19 | $1,862.09 |