- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,041.74 / $3,801.89 / $7,762.47
| Facility | | $2,041.74 | $3,801.89 | $7,762.47 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $2,187.76 / $5,128.61 / $9,332.54
| Facility | 50 | $2,187.76 | $5,128.61 | $9,332.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $309.03 / $812.83 / $3,311.31
| Professional | | $309.03 | $812.83 | $3,311.31 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $234.42 / $537.03 / $2,398.83
| Professional | 50 | $234.42 | $537.03 | $2,398.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $147.91 / $147.91 / $323.59
| Professional | | $147.91 | $147.91 | $323.59 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $223.87 / $223.87 / $512.86
| Professional | 50 | $223.87 | $223.87 | $512.86 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $79.43 / $346.74 / $660.69
| Facility | | $79.43 | $346.74 | $660.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $363.08 / $1,737.80 / $3,801.89
| Professional | | $363.08 | $1,737.80 | $3,801.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $616.60 / $616.60 / $616.60
| Facility | | $616.60 | $616.60 | $616.60 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $371.54 / $1,380.38 / $3,235.94
| Professional | | $371.54 | $1,380.38 | $3,235.94 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $380.19 / $1,995.26 / $6,456.54
| Facility | | $380.19 | $1,995.26 | $6,456.54 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $11,481.54 / $11,481.54 / $11,481.54
| Facility | 50 | $11,481.54 | $11,481.54 | $11,481.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,698.24 / $2,691.53 / $14,454.40
| Professional | | $1,698.24 | $2,691.53 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,677.35 / $6,606.93 / $10,715.19
| Facility | | $4,677.35 | $6,606.93 | $10,715.19 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $346.74 / $1,513.56 / $2,884.03
| Professional | | $346.74 | $1,513.56 | $2,884.03 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $89.13 / $89.13 / $89.13
| Professional | 50 | $89.13 | $89.13 | $89.13 |