- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,949.84 / $7,079.46 / $20,892.96
| Facility | | $1,949.84 | $7,079.46 | $20,892.96 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $30,199.52 / $30,199.52 / $30,199.52
| Facility | 50 | $30,199.52 | $30,199.52 | $30,199.52 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $309.03 / $1,202.26 / $2,818.38
| Professional | | $309.03 | $1,202.26 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $234.42 / $338.84 / $1,047.13
| Professional | 50 | $234.42 | $338.84 | $1,047.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $446.68 / $1,548.82 / $4,677.35
| Professional | | $446.68 | $1,548.82 | $4,677.35 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $363.08 / $1,621.81 / $3,981.07
| Facility | | $363.08 | $1,621.81 | $3,981.07 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $30,199.52 / $30,199.52 / $30,199.52
| Facility | 50 | $30,199.52 | $30,199.52 | $30,199.52 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $707.95 / $2,187.76 / $7,244.36
| Professional | | $707.95 | $2,187.76 | $7,244.36 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $234.42 / $234.42 / $338.84
| Professional | 50 | $234.42 | $234.42 | $338.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,318.26 / $5,754.40 / $8,709.64
| Professional | | $1,318.26 | $5,754.40 | $8,709.64 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $363.08 / $1,621.81 / $3,311.31
| Facility | | $363.08 | $1,621.81 | $3,311.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $436.52 / $1,445.44 / $4,365.16
| Professional | | $436.52 | $1,445.44 | $4,365.16 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,760.83 / $6,760.83 / $6,760.83
| Facility | | $6,760.83 | $6,760.83 | $6,760.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $478.63 / $1,819.70 / $4,265.80
| Professional | | $478.63 | $1,819.70 | $4,265.80 |