- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $144.54 / $2,630.27 / $7,413.10
| Facility | | $144.54 | $2,630.27 | $7,413.10 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $851.14 / $2,454.71 / $2,570.40
| Facility | 50 | $851.14 | $2,454.71 | $2,570.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $89.13 / $194.98 / $457.09
| Professional | | $89.13 | $194.98 | $457.09 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $125.89 / $426.58 / $1,122.02
| Professional | 50 | $125.89 | $426.58 | $1,122.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,819.70 / $3,630.78 / $5,011.87
| Facility | | $1,819.70 | $3,630.78 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $181.97 / $234.42 / $489.78
| Professional | | $181.97 | $234.42 | $489.78 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $275.42 / $346.74 / $691.83
| Professional | 50 | $275.42 | $346.74 | $691.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $104.71 / $104.71 / $104.71
| Facility | | $104.71 | $104.71 | $104.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $104.71 / $104.71 / $281.84
| Professional | | $104.71 | $104.71 | $281.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $128.82 / $1,318.26 / $53,703.18
| Facility | | $128.82 | $1,318.26 | $53,703.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $93.33 / $245.47 / $645.65
| Professional | | $93.33 | $245.47 | $645.65 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $39.81 / $79.43 / $177.83
| Facility | | $39.81 | $79.43 | $177.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $213.80 / $309.03 / $446.68
| Professional | | $213.80 | $309.03 | $446.68 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $138.04 / $190.55 / $371.54
| Professional | | $138.04 | $190.55 | $371.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $177.83 / $177.83 / $346.74
| Professional | | $177.83 | $177.83 | $346.74 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $407.38 / $407.38 / $407.38
| Professional | 50 | $407.38 | $407.38 | $407.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $407.38 / $407.38 / $3,388.44
| Facility | | $407.38 | $407.38 | $3,388.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $158.49 / $239.88 / $389.05
| Professional | | $158.49 | $239.88 | $389.05 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $229.09 / $363.08 / $575.44
| Professional | 50 | $229.09 | $363.08 | $575.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $107.15 / $50,118.72 / $75,857.76
| Facility | | $107.15 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $229.09 / $269.15 / $398.11
| Professional | | $229.09 | $269.15 | $398.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,096.48 / $2,454.71 / $4,897.79
| Facility | | $1,096.48 | $2,454.71 | $4,897.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $75.86 / $204.17 / $416.87
| Professional | | $75.86 | $204.17 | $416.87 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $60.26 / $93.33 / $316.23
| Facility | | $60.26 | $93.33 | $316.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $120.23 / $186.21 / $338.84
| Professional | | $120.23 | $186.21 | $338.84 |