- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $363.08 / $9,332.54 / $31,622.78
| Facility | | $363.08 | $9,332.54 | $31,622.78 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $4,677.35 / $19,054.61 / $19,054.61
| Facility | 50 | $4,677.35 | $19,054.61 | $19,054.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $309.03 / $724.44 / $3,019.95
| Professional | | $309.03 | $724.44 | $3,019.95 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $234.42 / $478.63 / $2,691.53
| Professional | 50 | $234.42 | $478.63 | $2,691.53 |
- 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
- Typical Low / Median / Typical High
- $660.69 / $2,398.83 / $7,079.46
| Professional | | $660.69 | $2,398.83 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $1,000.00 / $3,548.13 / $10,471.29
| Professional | 50 | $1,000.00 | $3,548.13 | $10,471.29 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,248.07 / $7,585.78 / $17,782.79
| Facility | | $5,248.07 | $7,585.78 | $17,782.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $512.86 / $1,659.59 / $7,244.36
| Professional | | $512.86 | $1,659.59 | $7,244.36 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,754.40 / $7,079.46 / $13,803.84
| Facility | | $5,754.40 | $7,079.46 | $13,803.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $724.44 / $2,884.03 / $7,413.10
| Professional | | $724.44 | $2,884.03 | $7,413.10 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $457.09 / $2,137.96 / $5,888.44
| Facility | | $457.09 | $2,137.96 | $5,888.44 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $0.59 / $19,054.61 / $29,512.09
| Facility | 50 | $0.59 | $19,054.61 | $29,512.09 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,905.46 / $3,630.78 / $14,454.40
| Professional | | $1,905.46 | $3,630.78 | $14,454.40 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $676.08 / $1,202.26 / $3,801.89
| Professional | 50 | $676.08 | $1,202.26 | $3,801.89 |
- 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 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $489.78 / $2,290.87 / $4,570.88
| Professional | | $489.78 | $2,290.87 | $4,570.88 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $75.86 / $75.86 / $75.86
| Professional | 50 | $75.86 | $75.86 | $75.86 |