- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $602.56 / $8,709.64 / $20,892.96
| Facility | | $602.56 | $8,709.64 | $20,892.96 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $9,120.11 / $19,054.61 / $26,915.35
| Facility | 50 | $9,120.11 | $19,054.61 | $26,915.35 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $331.13 / $1,258.93 / $6,165.95
| Professional | | $331.13 | $1,258.93 | $6,165.95 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $549.54 / $741.31 / $9,120.11
| Professional | 50 | $549.54 | $741.31 | $9,120.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $354.81 / $933.25 / $1,737.80
| Professional | | $354.81 | $933.25 | $1,737.80 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,456.54 / $8,709.64 / $17,378.01
| Facility | | $6,456.54 | $8,709.64 | $17,378.01 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $9,772.37 / $13,182.57 / $25,703.96
| Facility | 50 | $9,772.37 | $13,182.57 | $25,703.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $371.54 / $831.76 / $2,511.89
| Professional | | $371.54 | $831.76 | $2,511.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,801.89 / $3,801.89 / $3,801.89
| Facility | | $3,801.89 | $3,801.89 | $3,801.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $389.05 / $870.96 / $3,235.94
| Professional | | $389.05 | $870.96 | $3,235.94 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $489.78 / $2,290.87 / $12,022.64
| Facility | | $489.78 | $2,290.87 | $12,022.64 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $12,022.64 / $13,803.84 / $23,442.29
| Facility | 50 | $12,022.64 | $13,803.84 | $23,442.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $489.78 / $1,819.70 / $3,801.89
| Professional | | $489.78 | $1,819.70 | $3,801.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $169.82
| Professional | | $32.36 | $33.11 | $169.82 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,548.82 / $1,995.26 / $2,691.53
| Facility | | $1,548.82 | $1,995.26 | $2,691.53 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,445.44 / $1,513.56 / $1,513.56
| Facility | | $1,445.44 | $1,513.56 | $1,513.56 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $371.54 / $1,445.44 / $2,570.40
| Professional | | $371.54 | $1,445.44 | $2,570.40 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,606.93 / $8,912.51 / $17,378.01
| Facility | | $6,606.93 | $8,912.51 | $17,378.01 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $10,000.00 / $13,182.57 / $25,703.96
| Facility | 50 | $10,000.00 | $13,182.57 | $25,703.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $371.54 / $831.76 / $2,454.71
| Professional | | $371.54 | $831.76 | $2,454.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,884.03 / $10,232.93 / $18,197.01
| Facility | | $2,884.03 | $10,232.93 | $18,197.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $398.11 / $1,047.13 / $2,754.23
| Professional | | $398.11 | $1,047.13 | $2,754.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $275.42 / $489.78 / $2,398.83
| Professional | | $275.42 | $489.78 | $2,398.83 |