- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $323.59 / $1,862.09 / $15,488.17
| Facility | | $323.59 | $1,862.09 | $15,488.17 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $1,258.93 / $19,054.61 / $19,054.61
| Facility | 50 | $1,258.93 | $19,054.61 | $19,054.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $309.03 / $851.14 / $2,454.71
| Professional | | $309.03 | $851.14 | $2,454.71 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $346.74 / $562.34 / $2,570.40
| Professional | 50 | $346.74 | $562.34 | $2,570.40 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7,244.36 / $12,882.50 / $24,547.09
| Facility | | $7,244.36 | $12,882.50 | $24,547.09 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $12,589.25 / $20,892.96 / $57,543.99
| Facility | 50 | $12,589.25 | $20,892.96 | $57,543.99 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $588.84 / $2,089.30 / $5,888.44
| Professional | | $588.84 | $2,089.30 | $5,888.44 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $891.25 / $3,090.30 / $8,912.51
| Professional | 50 | $891.25 | $3,090.30 | $8,912.51 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,801.89 / $6,309.57 / $14,791.08
| Facility | | $3,801.89 | $6,309.57 | $14,791.08 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $457.09 / $1,513.56 / $6,165.95
| Professional | | $457.09 | $1,513.56 | $6,165.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,786.30 / $5,888.44 / $11,748.98
| Facility | | $4,786.30 | $5,888.44 | $11,748.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $660.69 / $2,454.71 / $5,754.40
| Professional | | $660.69 | $2,454.71 | $5,754.40 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $407.38 / $1,819.70 / $4,786.30
| Facility | | $407.38 | $1,819.70 | $4,786.30 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $8,912.51 / $9,772.37 / $16,218.10
| Facility | 50 | $8,912.51 | $9,772.37 | $16,218.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,659.59 / $3,019.95 / $12,022.64
| Professional | | $1,659.59 | $3,019.95 | $12,022.64 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $602.56 / $933.25 / $3,235.94
| Professional | 50 | $602.56 | $933.25 | $3,235.94 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,584.89 / $6,309.57 / $14,454.40
| Facility | | $1,584.89 | $6,309.57 | $14,454.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $380.19 / $1,659.59 / $4,897.79
| Professional | | $380.19 | $1,659.59 | $4,897.79 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $75.86 / $75.86 / $75.86
| Professional | 50 | $75.86 | $75.86 | $75.86 |