- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $436.52 / $2,187.76 / $19,498.45
| Facility | | $436.52 | $2,187.76 | $19,498.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $288.40 / $645.65 / $2,454.71
| Professional | | $288.40 | $645.65 | $2,454.71 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $363.08 / $794.33 / $5,011.87
| Professional | 50 | $363.08 | $794.33 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $169.82 / $257.04 / $323.59
| Professional | | $169.82 | $257.04 | $323.59 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $177.83 / $177.83 / $229.09
| Professional | 50 | $177.83 | $177.83 | $229.09 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9,549.93 / $10,715.19 / $11,220.18
| Facility | | $9,549.93 | $10,715.19 | $11,220.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $263.03 / $575.44 / $1,778.28
| Professional | | $263.03 | $575.44 | $1,778.28 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $398.11 / $851.14 / $2,630.27
| Professional | 50 | $398.11 | $851.14 | $2,630.27 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $269.15 / $371.54 / $478.63
| Facility | | $269.15 | $371.54 | $478.63 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $354.81 / $1,288.25 / $1,698.24
| Professional | | $354.81 | $1,288.25 | $1,698.24 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $34.67 / $501.19 / $501.19
| Facility | | $34.67 | $501.19 | $501.19 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $331.13 / $1,380.38 / $6,760.83
| Professional | | $331.13 | $1,380.38 | $6,760.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $309.03
| Professional | | $32.36 | $33.11 | $309.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $58.88 / $933.25 / $2,884.03
| Facility | | $58.88 | $933.25 | $2,884.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $316.23 / $812.83 / $2,951.21
| Professional | | $316.23 | $812.83 | $2,951.21 |