- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $851.14 / $4,786.30 / $19,952.62
| Facility | | $851.14 | $4,786.30 | $19,952.62 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $4,073.80 / $9,120.11 / $28,183.83
| Facility | 50 | $4,073.80 | $9,120.11 | $28,183.83 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $467.74 / $1,230.27 / $7,413.10
| Professional | 50 | $467.74 | $1,230.27 | $7,413.10 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $501.19 / $794.33 / $977.24
| Professional | 50 | $501.19 | $794.33 | $977.24 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,570.40 / $3,467.37 / $52,480.75
| Facility | | $2,570.40 | $3,467.37 | $52,480.75 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9,549.93 / $10,000.00 / $57,543.99
| Facility | | $9,549.93 | $10,000.00 | $57,543.99 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $2,884.03 / $3,019.95 / $5,128.61
| Professional | 50 | $2,884.03 | $3,019.95 | $5,128.61 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,148.15 / $12,882.50 / $28,840.32
| Facility | | $1,148.15 | $12,882.50 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $2,290.87 / $14,125.38 / $30,199.52
| Facility | 50 | $2,290.87 | $14,125.38 | $30,199.52 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $676.08 / $724.44 / $3,235.94
| Professional | 50 | $676.08 | $724.44 | $3,235.94 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,137.96 / $3,162.28 / $28,840.32
| Facility | | $2,137.96 | $3,162.28 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $588.84 / $3,311.31 / $8,317.64
| Facility | | $588.84 | $3,311.31 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $28,183.83 / $33,113.11 / $56,234.13
| Facility | 50 | $28,183.83 | $33,113.11 | $56,234.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $316.23 / $1,479.11 / $2,511.89
| Facility | | $316.23 | $1,479.11 | $2,511.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,019.95 / $6,309.57 / $17,782.79
| Facility | | $3,019.95 | $6,309.57 | $17,782.79 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $79.43 / $79.43 / $79.43
| Professional | 50 | $79.43 | $79.43 | $79.43 |