- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $954.99 / $5,754.40 / $12,302.69
| Facility | | $954.99 | $5,754.40 | $12,302.69 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $3,630.78 / $8,511.38 / $12,882.50
| Facility | 50 | $3,630.78 | $8,511.38 | $12,882.50 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $467.74 / $1,202.26 / $6,760.83
| Professional | 50 | $467.74 | $1,202.26 | $6,760.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,073.80 / $7,762.47 / $13,803.84
| Facility | | $4,073.80 | $7,762.47 | $13,803.84 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $2,137.96 / $2,630.27 / $6,606.93
| Professional | 50 | $2,137.96 | $2,630.27 | $6,606.93 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $501.19 / $501.19 / $12,302.69
| Facility | | $501.19 | $501.19 | $12,302.69 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $34.67 / $630.96 / $7,762.47
| Facility | | $34.67 | $630.96 | $7,762.47 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $398.11 / $512.86 / $1,318.26
| Facility | | $398.11 | $512.86 | $1,318.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,365.16 / $7,585.78 / $19,054.61
| Facility | | $4,365.16 | $7,585.78 | $19,054.61 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $5,623.41 / $7,079.46 / $11,220.18
| Facility | 50 | $5,623.41 | $7,079.46 | $11,220.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $389.05 / $6,606.93 / $50,118.72
| Facility | | $389.05 | $6,606.93 | $50,118.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,454.71 / $6,309.57 / $13,803.84
| Facility | | $2,454.71 | $6,309.57 | $13,803.84 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $79.43 / $79.43 / $79.43
| Professional | 50 | $79.43 | $79.43 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $288.40 / $457.09 / $707.95
| Facility | | $288.40 | $457.09 | $707.95 |