- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $467.74 / $3,311.31 / $8,317.64
| Facility | | $467.74 | $3,311.31 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $3,467.37 / $5,128.61 / $19,498.45
| Facility | 50 | $3,467.37 | $5,128.61 | $19,498.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $309.03 / $1,122.02 / $2,951.21
| Professional | | $309.03 | $1,122.02 | $2,951.21 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $426.58 / $912.01 / $4,677.35
| Professional | 50 | $426.58 | $912.01 | $4,677.35 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $398.11 / $398.11 / $398.11
| Professional | | $398.11 | $398.11 | $398.11 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $3,801.89 / $3,801.89 / $3,801.89
| Professional | 50 | $3,801.89 | $3,801.89 | $3,801.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $575.44 / $1,548.82 / $4,466.84
| Professional | | $575.44 | $1,548.82 | $4,466.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $371.54 / $1,202.26 / $3,715.35
| Professional | | $371.54 | $1,202.26 | $3,715.35 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $331.13 / $1,513.56 / $3,235.94
| Facility | | $331.13 | $1,513.56 | $3,235.94 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $338.84 / $2,290.87 / $5,888.44
| Professional | | $338.84 | $2,290.87 | $5,888.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,265.80 / $13,803.84 / $23,442.29
| Facility | | $4,265.80 | $13,803.84 | $23,442.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $323.59 / $1,445.44 / $3,162.28
| Professional | | $323.59 | $1,445.44 | $3,162.28 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $75.86 / $75.86 / $79.43
| Professional | 50 | $75.86 | $75.86 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $56.23 / $14,454.40 / $14,454.40
| Facility | | $56.23 | $14,454.40 | $14,454.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11,748.98 / $11,748.98 / $14,125.38
| Professional | | $11,748.98 | $11,748.98 | $14,125.38 |