- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $467.74 / $4,897.79 / $14,454.40
| Facility | | $467.74 | $4,897.79 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $977.24 / $19,498.45 / $29,512.09
| Facility | 50 | $977.24 | $19,498.45 | $29,512.09 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $309.03 / $794.33 / $3,019.95
| Professional | | $309.03 | $794.33 | $3,019.95 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $239.88 / $691.83 / $2,454.71
| Professional | 50 | $239.88 | $691.83 | $2,454.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $177.83 / $251.19 / $501.19
| Professional | | $177.83 | $251.19 | $501.19 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $204.17 / $380.19 / $912.01
| Professional | 50 | $204.17 | $380.19 | $912.01 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7,244.36 / $18,197.01 / $26,302.68
| Facility | | $7,244.36 | $18,197.01 | $26,302.68 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $323.59 / $1,318.26 / $2,951.21
| Professional | | $323.59 | $1,318.26 | $2,951.21 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $489.78 / $1,995.26 / $4,365.16
| Professional | 50 | $489.78 | $1,995.26 | $4,365.16 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $323.59 / $426.58 / $575.44
| Facility | | $323.59 | $426.58 | $575.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,737.80 / $2,137.96 / $2,691.53
| Professional | | $1,737.80 | $2,137.96 | $2,691.53 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $371.54 / $1,000.00 / $3,235.94
| Professional | | $371.54 | $1,000.00 | $3,235.94 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,548.13 / $10,715.19 / $17,782.79
| Facility | | $3,548.13 | $10,715.19 | $17,782.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $354.81 / $1,584.89 / $3,090.30
| Professional | | $354.81 | $1,584.89 | $3,090.30 |