- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $436.52 / $3,162.28 / $17,782.79
| Facility | | $436.52 | $3,162.28 | $17,782.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $436.52 / $1,174.90 / $4,570.88
| Professional | | $436.52 | $1,174.90 | $4,570.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15,135.61 / $28,183.83 / $81,283.05
| Facility | | $15,135.61 | $28,183.83 | $81,283.05 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $26,915.35 / $42,657.95 / $120,226.44
| Facility | 50 | $26,915.35 | $42,657.95 | $120,226.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $741.31 / $3,162.28 / $8,317.64
| Professional | | $741.31 | $3,162.28 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7,079.46 / $10,232.93 / $24,547.09
| Facility | | $7,079.46 | $10,232.93 | $24,547.09 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $870.96 / $2,754.23 / $11,220.18
| Professional | | $870.96 | $2,754.23 | $11,220.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7,585.78 / $9,332.54 / $18,197.01
| Facility | | $7,585.78 | $9,332.54 | $18,197.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $870.96 / $3,801.89 / $9,772.37
| Professional | | $870.96 | $3,801.89 | $9,772.37 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $691.83 / $5,370.32 / $29,512.09
| Facility | | $691.83 | $5,370.32 | $29,512.09 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,630.78 / $7,413.10 / $14,454.40
| Professional | | $3,630.78 | $7,413.10 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,584.89 / $11,748.98 / $53,703.18
| Facility | | $1,584.89 | $11,748.98 | $53,703.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $630.96 / $2,630.27 / $10,471.29
| Professional | | $630.96 | $2,630.27 | $10,471.29 |