- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $851.14 / $4,677.35 / $11,481.54
| Facility | | $851.14 | $4,677.35 | $11,481.54 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $16,218.10 / $16,218.10 / $19,498.45
| Facility | 50 | $16,218.10 | $16,218.10 | $19,498.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $316.23 / $1,202.26 / $2,884.03
| Professional | | $316.23 | $1,202.26 | $2,884.03 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $1,202.26 / $1,862.09 / $5,128.61
| Professional | 50 | $1,202.26 | $1,862.09 | $5,128.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $371.54 / $977.24 / $1,698.24
| Professional | | $371.54 | $977.24 | $1,698.24 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,318.26 / $3,630.78 / $11,220.18
| Facility | | $1,318.26 | $3,630.78 | $11,220.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $295.12 / $870.96 / $1,819.70
| Professional | | $295.12 | $870.96 | $1,819.70 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $467.74 / $1,584.89 / $1,905.46
| Facility | | $467.74 | $1,584.89 | $1,905.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $275.42 / $891.25 / $2,511.89
| Professional | | $275.42 | $891.25 | $2,511.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,466.84 / $9,120.11 / $16,982.44
| Facility | | $4,466.84 | $9,120.11 | $16,982.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $724.44 / $776.25 / $1,513.56
| Professional | | $724.44 | $776.25 | $1,513.56 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $1,318.26
| Professional | | $32.36 | $33.11 | $1,318.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,630.27 / $7,413.10 / $12,302.69
| Facility | | $2,630.27 | $7,413.10 | $12,302.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $281.84 / $1,047.13 / $2,630.27
| Professional | | $281.84 | $1,047.13 | $2,630.27 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $208.93 / $776.25 / $1,096.48
| Professional | | $208.93 | $776.25 | $1,096.48 |