- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $933.25 / $4,677.35 / $10,471.29
| Facility | | $933.25 | $4,677.35 | $10,471.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $309.03 / $1,023.29 / $2,290.87
| Professional | | $309.03 | $1,023.29 | $2,290.87 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $2,454.71 / $2,884.03 / $6,025.60
| Professional | 50 | $2,454.71 | $2,884.03 | $6,025.60 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $707.95 / $870.96 / $1,047.13
| Professional | | $707.95 | $870.96 | $1,047.13 |
- 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 / $812.83 / $1,513.56
| Professional | | $295.12 | $812.83 | $1,513.56 |
- 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 / $812.83 / $2,089.30
| Professional | | $275.42 | $812.83 | $2,089.30 |
- 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
- $676.08 / $724.44 / $1,348.96
| Professional | | $676.08 | $724.44 | $1,348.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $1,096.48
| Professional | | $32.36 | $33.11 | $1,096.48 |
- 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
- $288.40 / $870.96 / $2,187.76
| Professional | | $288.40 | $870.96 | $2,187.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $208.93 / $724.44 / $1,023.29
| Professional | | $208.93 | $724.44 | $1,023.29 |