- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $363.08 / $14,454.40 / $33,884.42
| Facility | | $363.08 | $14,454.40 | $33,884.42 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $6,606.93 / $27,542.29 / $27,542.29
| Facility | 50 | $6,606.93 | $27,542.29 | $27,542.29 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $501.19 / $870.96 / $3,019.95
| Professional | 50 | $501.19 | $870.96 | $3,019.95 |
- 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
- 50
- Typical Low / Median / Typical High
- $1,000.00 / $3,630.78 / $10,964.78
| Professional | 50 | $1,000.00 | $3,630.78 | $10,964.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,370.32 / $7,762.47 / $18,197.01
| Facility | | $5,370.32 | $7,762.47 | $18,197.01 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,888.44 / $7,244.36 / $14,125.38
| Facility | | $5,888.44 | $7,244.36 | $14,125.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $457.09 / $2,187.76 / $6,165.95
| Facility | | $457.09 | $2,187.76 | $6,165.95 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $9,549.93 / $19,054.61 / $32,359.37
| Facility | 50 | $9,549.93 | $19,054.61 | $32,359.37 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $1,023.29 / $1,737.80 / $4,365.16
| Professional | 50 | $1,023.29 | $1,737.80 | $4,365.16 |
- 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 |