- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $707.95 / $3,715.35 / $8,709.64
| Facility | | $707.95 | $3,715.35 | $8,709.64 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $6,918.31 / $18,197.01 / $27,542.29
| Facility | 50 | $6,918.31 | $18,197.01 | $27,542.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $309.03 / $1,122.02 / $3,311.31
| Professional | | $309.03 | $1,122.02 | $3,311.31 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $512.86 / $1,096.48 / $5,754.40
| Professional | 50 | $512.86 | $1,096.48 | $5,754.40 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $562.34 / $562.34 / $562.34
| Facility | | $562.34 | $562.34 | $562.34 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $436.52 / $1,659.59 / $4,466.84
| Professional | | $436.52 | $1,659.59 | $4,466.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $562.34 / $812.83 / $4,677.35
| Professional | | $562.34 | $812.83 | $4,677.35 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $363.08 / $1,548.82 / $3,890.45
| Facility | | $363.08 | $1,548.82 | $3,890.45 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $6,918.31 / $18,197.01 / $27,542.29
| Facility | 50 | $6,918.31 | $18,197.01 | $27,542.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $501.19 / $1,659.59 / $4,365.16
| Professional | | $501.19 | $1,659.59 | $4,365.16 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $489.78 / $1,047.13 / $3,630.78
| Professional | 50 | $489.78 | $1,047.13 | $3,630.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,949.84 / $3,090.30 / $3,235.94
| Facility | | $1,949.84 | $3,090.30 | $3,235.94 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $354.81 / $1,548.82 / $3,715.35
| Facility | | $354.81 | $1,548.82 | $3,715.35 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $389.05 / $933.25 / $4,365.16
| Professional | | $389.05 | $933.25 | $4,365.16 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12,882.50 / $18,197.01 / $21,877.62
| Facility | | $12,882.50 | $18,197.01 | $21,877.62 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $19,498.45 / $26,915.35 / $33,113.11
| Facility | 50 | $19,498.45 | $26,915.35 | $33,113.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $602.56 / $2,137.96 / $4,365.16
| Professional | | $602.56 | $2,137.96 | $4,365.16 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7,943.28 / $20,892.96 / $26,302.68
| Facility | | $7,943.28 | $20,892.96 | $26,302.68 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $407.38 / $1,380.38 / $3,890.45
| Professional | | $407.38 | $1,380.38 | $3,890.45 |