- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $616.60 / $5,128.61 / $17,378.01
| Facility | | $616.60 | $5,128.61 | $17,378.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $323.59 / $1,258.93 / $3,388.44
| Professional | | $323.59 | $1,258.93 | $3,388.44 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $549.54 / $741.31 / $1,202.26
| Professional | 50 | $549.54 | $741.31 | $1,202.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $436.52 / $1,096.48 / $3,090.30
| Professional | | $436.52 | $1,096.48 | $3,090.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $457.09 / $676.08 / $2,630.27
| Professional | | $457.09 | $676.08 | $2,630.27 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $371.54 / $1,819.70 / $9,549.93
| Facility | | $371.54 | $1,819.70 | $9,549.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $426.58 / $1,445.44 / $3,311.31
| Professional | | $426.58 | $1,445.44 | $3,311.31 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $549.54 / $741.31 / $1,202.26
| Professional | 50 | $549.54 | $741.31 | $1,202.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,584.89 / $1,995.26 / $3,090.30
| Facility | | $1,584.89 | $1,995.26 | $3,090.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $363.08 / $1,445.44 / $3,890.45
| Facility | | $363.08 | $1,445.44 | $3,890.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $79.43 / $707.95 / $3,019.95
| Professional | | $79.43 | $707.95 | $3,019.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7,762.47 / $10,964.78 / $12,882.50
| Facility | | $7,762.47 | $10,964.78 | $12,882.50 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $11,748.98 / $16,218.10 / $19,054.61
| Facility | 50 | $11,748.98 | $16,218.10 | $19,054.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $549.54 / $933.25 / $3,162.28
| Professional | | $549.54 | $933.25 | $3,162.28 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,073.80 / $12,882.50 / $25,118.86
| Facility | | $4,073.80 | $12,882.50 | $25,118.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $446.68 / $1,202.26 / $3,388.44
| Professional | | $446.68 | $1,202.26 | $3,388.44 |