- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $436.52 / $1,949.84 / $1,949.84
| Facility | | $436.52 | $1,949.84 | $1,949.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $416.87 / $1,096.48 / $2,951.21
| Professional | | $416.87 | $1,096.48 | $2,951.21 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8,709.64 / $34,673.69 / $81,283.05
| Facility | | $8,709.64 | $34,673.69 | $81,283.05 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $36,307.81 / $67,608.30 / $190,546.07
| Facility | 50 | $36,307.81 | $67,608.30 | $190,546.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $741.31 / $2,089.30 / $5,370.32
| Professional | | $741.31 | $2,089.30 | $5,370.32 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,365.16 / $6,309.57 / $15,135.61
| Facility | | $4,365.16 | $6,309.57 | $15,135.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $891.25 / $2,754.23 / $7,079.46
| Professional | | $891.25 | $2,754.23 | $7,079.46 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,677.35 / $5,888.44 / $11,481.54
| Facility | | $4,677.35 | $5,888.44 | $11,481.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $870.96 / $2,691.53 / $5,754.40
| Professional | | $870.96 | $2,691.53 | $5,754.40 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $691.83 / $3,388.44 / $12,022.64
| Facility | | $691.83 | $3,388.44 | $12,022.64 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $3,090.30 / $3,090.30 / $3,090.30
| Facility | 50 | $3,090.30 | $3,090.30 | $3,090.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,187.76 / $4,168.69 / $8,317.64
| Professional | | $2,187.76 | $4,168.69 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,897.79 / $10,000.00 / $47,863.01
| Facility | | $4,897.79 | $10,000.00 | $47,863.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $630.96 / $2,137.96 / $6,165.95
| Professional | | $630.96 | $2,137.96 | $6,165.95 |