- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $309.03 / $11,481.54 / $34,673.69
| Facility | | $309.03 | $11,481.54 | $34,673.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $302.00 / $812.83 / $5,495.41
| Professional | | $302.00 | $812.83 | $5,495.41 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $676.08 / $794.33 / $2,238.72
| Professional | 50 | $676.08 | $794.33 | $2,238.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,011.87 / $21,877.62 / $51,286.14
| Facility | | $5,011.87 | $21,877.62 | $51,286.14 |
- 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
- $524.81 / $2,238.72 / $10,471.29
| Professional | | $524.81 | $2,238.72 | $10,471.29 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8,128.31 / $12,882.50 / $30,902.95
| Facility | | $8,128.31 | $12,882.50 | $30,902.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $616.60 / $1,949.84 / $14,125.38
| Professional | | $616.60 | $1,949.84 | $14,125.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9,549.93 / $11,748.98 / $23,442.29
| Facility | | $9,549.93 | $11,748.98 | $23,442.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $616.60 / $1,905.46 / $12,302.69
| Professional | | $616.60 | $1,905.46 | $12,302.69 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $489.78 / $7,585.78 / $29,512.09
| Facility | | $489.78 | $7,585.78 | $29,512.09 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4,466.84 / $7,585.78 / $13,489.63
| Professional | | $4,466.84 | $7,585.78 | $13,489.63 |
- 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
- $446.68 / $3,311.31 / $11,220.18
| Professional | | $446.68 | $3,311.31 | $11,220.18 |