- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,122.02 / $4,466.84 / $5,888.44
| Facility | | $1,122.02 | $4,466.84 | $5,888.44 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $10,471.29 / $10,471.29 / $10,471.29
| Facility | 50 | $10,471.29 | $10,471.29 | $10,471.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $302.00 / $1,122.02 / $3,311.31
| Professional | | $302.00 | $1,122.02 | $3,311.31 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $346.74 / $724.44 / $2,570.40
| Professional | 50 | $346.74 | $724.44 | $2,570.40 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,905.46 / $6,760.83 / $14,125.38
| Facility | | $1,905.46 | $6,760.83 | $14,125.38 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $2,691.53 / $10,232.93 / $21,379.62
| Facility | 50 | $2,691.53 | $10,232.93 | $21,379.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $537.03 / $2,454.71 / $3,235.94
| Professional | | $537.03 | $2,454.71 | $3,235.94 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $776.25 / $933.25 / $4,786.30
| Professional | 50 | $776.25 | $933.25 | $4,786.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $380.19 / $1,513.56 / $2,884.03
| Professional | | $380.19 | $1,513.56 | $2,884.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,344.23 / $2,344.23 / $3,235.94
| Professional | | $2,344.23 | $2,344.23 | $3,235.94 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $354.81 / $1,659.59 / $3,630.78
| Facility | | $354.81 | $1,659.59 | $3,630.78 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $10,471.29 / $10,471.29 / $10,471.29
| Facility | 50 | $10,471.29 | $10,471.29 | $10,471.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $446.68 / $1,230.27 / $4,073.80
| Professional | | $446.68 | $1,230.27 | $4,073.80 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $346.74 / $575.44 / $2,570.40
| Professional | 50 | $346.74 | $575.44 | $2,570.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $660.69 / $1,071.52
| Professional | | $32.36 | $660.69 | $1,071.52 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9,332.54 / $12,302.69 / $17,782.79
| Facility | | $9,332.54 | $12,302.69 | $17,782.79 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $13,803.84 / $19,952.62 / $26,915.35
| Facility | 50 | $13,803.84 | $19,952.62 | $26,915.35 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $549.54 / $794.33 / $3,467.37
| Professional | | $549.54 | $794.33 | $3,467.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $588.84 / $1,737.80 / $8,511.38
| Professional | | $588.84 | $1,737.80 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11,748.98 / $26,915.35 / $29,512.09
| Facility | | $11,748.98 | $26,915.35 | $29,512.09 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $346.74 / $1,047.13 / $2,884.03
| Professional | | $346.74 | $1,047.13 | $2,884.03 |