- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $870.96 / $7,943.28 / $13,182.57
| Facility | | $870.96 | $7,943.28 | $13,182.57 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $5,623.41 / $8,912.51 / $21,877.62
| Facility | 50 | $5,623.41 | $8,912.51 | $21,877.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $331.13 / $912.01 / $3,715.35
| Professional | | $331.13 | $912.01 | $3,715.35 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $234.42 / $812.83 / $2,884.03
| Professional | 50 | $234.42 | $812.83 | $2,884.03 |
- 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
- $478.63 / $1,862.09 / $5,370.32
| Professional | | $478.63 | $1,862.09 | $5,370.32 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $616.60 / $912.01 / $5,495.41
| Professional | | $616.60 | $912.01 | $5,495.41 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $407.38 / $1,949.84 / $4,897.79
| Facility | | $407.38 | $1,949.84 | $4,897.79 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $5,623.41 / $8,912.51 / $20,417.38
| Facility | 50 | $5,623.41 | $8,912.51 | $20,417.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $562.34 / $1,698.24 / $5,248.07
| Professional | | $562.34 | $1,698.24 | $5,248.07 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $234.42 / $616.60 / $2,884.03
| Professional | 50 | $234.42 | $616.60 | $2,884.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,290.87 / $3,715.35 / $3,890.45
| Facility | | $2,290.87 | $3,715.35 | $3,890.45 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $398.11 / $1,819.70 / $4,365.16
| Facility | | $398.11 | $1,819.70 | $4,365.16 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $446.68 / $1,047.13 / $5,370.32
| Professional | | $446.68 | $1,047.13 | $5,370.32 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12,882.50 / $18,197.01 / $21,877.62
| Facility | | $12,882.50 | $18,197.01 | $21,877.62 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $19,498.45 / $26,915.35 / $33,113.11
| Facility | 50 | $19,498.45 | $26,915.35 | $33,113.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $676.08 / $2,570.40 / $5,248.07
| Professional | | $676.08 | $2,570.40 | $5,248.07 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7,943.28 / $20,892.96 / $26,302.68
| Facility | | $7,943.28 | $20,892.96 | $26,302.68 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $446.68 / $1,621.81 / $4,786.30
| Professional | | $446.68 | $1,621.81 | $4,786.30 |