- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,000.00 / $6,165.95 / $21,877.62
| Facility | | $1,000.00 | $6,165.95 | $21,877.62 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $10,232.93 / $22,387.21 / $22,387.21
| Facility | 50 | $10,232.93 | $22,387.21 | $22,387.21 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $309.03 / $3,019.95 / $7,244.36
| Professional | | $309.03 | $3,019.95 | $7,244.36 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $676.08 / $676.08 / $870.96
| Professional | 50 | $676.08 | $676.08 | $870.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $134.90 / $537.03 / $2,951.21
| Professional | | $134.90 | $537.03 | $2,951.21 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $4,168.69 / $4,168.69 / $4,168.69
| Professional | 50 | $4,168.69 | $4,168.69 | $4,168.69 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,995.26 / $7,413.10 / $12,302.69
| Facility | | $1,995.26 | $7,413.10 | $12,302.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $302.00 / $2,691.53 / $3,467.37
| Professional | | $302.00 | $2,691.53 | $3,467.37 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $323.59 / $7,079.46 / $8,511.38
| Facility | | $323.59 | $7,079.46 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $302.00 / $1,071.52 / $5,888.44
| Professional | | $302.00 | $1,071.52 | $5,888.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8,912.51 / $25,118.86 / $45,708.82
| Facility | | $8,912.51 | $25,118.86 | $45,708.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,238.72 / $2,398.83 / $4,073.80
| Professional | | $2,238.72 | $2,398.83 | $4,073.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $3,981.07
| Professional | | $32.36 | $33.11 | $3,981.07 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,025.60 / $15,135.61 / $30,199.52
| Facility | | $6,025.60 | $15,135.61 | $30,199.52 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $309.03 / $2,344.23 / $6,309.57
| Professional | | $309.03 | $2,344.23 | $6,309.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $229.09 / $2,290.87 / $3,311.31
| Professional | | $229.09 | $2,290.87 | $3,311.31 |