- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $512.86 / $4,073.80 / $12,022.64
| Facility | | $512.86 | $4,073.80 | $12,022.64 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $8,709.64 / $10,000.00 / $18,197.01
| Facility | 50 | $8,709.64 | $10,000.00 | $18,197.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $323.59 / $1,258.93 / $3,019.95
| Professional | | $323.59 | $1,258.93 | $3,019.95 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $549.54 / $741.31 / $5,128.61
| Professional | 50 | $549.54 | $741.31 | $5,128.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $891.25 / $891.25 / $891.25
| Professional | | $891.25 | $891.25 | $891.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,388.44 / $5,495.41 / $12,882.50
| Facility | | $3,388.44 | $5,495.41 | $12,882.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,023.29 / $1,318.26 / $4,365.16
| Professional | | $1,023.29 | $1,318.26 | $4,365.16 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $1,513.56 / $1,995.26 / $6,025.60
| Professional | 50 | $1,513.56 | $1,995.26 | $6,025.60 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $389.05 / $4,265.80 / $16,595.87
| Facility | | $389.05 | $4,265.80 | $16,595.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $389.05 / $389.05 / $1,819.70
| Professional | | $389.05 | $389.05 | $1,819.70 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $467.74 / $4,365.16 / $53,703.18
| Facility | | $467.74 | $4,365.16 | $53,703.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $331.13 / $1,380.38 / $5,754.40
| Professional | | $331.13 | $1,380.38 | $5,754.40 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $295.12 / $416.87 / $954.99
| Facility | | $295.12 | $416.87 | $954.99 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,096.48 / $1,621.81 / $2,290.87
| Professional | | $1,096.48 | $1,621.81 | $2,290.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $933.25 / $1,412.54 / $1,949.84
| Professional | | $933.25 | $1,412.54 | $1,949.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $891.25 / $891.25 / $912.01
| Professional | | $891.25 | $891.25 | $912.01 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,548.13 / $7,413.10 / $17,378.01
| Facility | | $3,548.13 | $7,413.10 | $17,378.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $338.84 / $1,659.59 / $2,570.40
| Professional | | $338.84 | $1,659.59 | $2,570.40 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $371.54 / $50,118.72 / $75,857.76
| Facility | | $371.54 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $398.11 / $1,778.28 / $2,041.74
| Professional | | $398.11 | $1,778.28 | $2,041.74 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,344.23 / $4,897.79 / $10,232.93
| Facility | | $2,344.23 | $4,897.79 | $10,232.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $281.84 / $1,202.26 / $2,951.21
| Professional | | $281.84 | $1,202.26 | $2,951.21 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $218.78 / $346.74 / $1,348.96
| Facility | | $218.78 | $346.74 | $1,348.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $724.44 / $1,230.27 / $2,187.76
| Professional | | $724.44 | $1,230.27 | $2,187.76 |