- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $676.08 / $7,585.78 / $16,595.87
| Facility | | $676.08 | $7,585.78 | $16,595.87 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $37,153.52 / $37,153.52 / $37,153.52
| Facility | 50 | $37,153.52 | $37,153.52 | $37,153.52 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $309.03 / $3,467.37 / $8,128.31
| Professional | | $309.03 | $3,467.37 | $8,128.31 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $676.08 / $676.08 / $794.33
| Professional | 50 | $676.08 | $676.08 | $794.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $416.87 / $416.87 / $416.87
| Professional | | $416.87 | $416.87 | $416.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $512.86 / $5,011.87 / $10,471.29
| Professional | | $512.86 | $5,011.87 | $10,471.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $407.38 / $1,023.29 / $7,585.78
| Professional | | $407.38 | $1,023.29 | $7,585.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $295.12 / $2,570.40 / $5,888.44
| Facility | | $295.12 | $2,570.40 | $5,888.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $416.87 / $467.74 / $5,248.07
| Professional | | $416.87 | $467.74 | $5,248.07 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9,549.93 / $21,379.62 / $30,902.95
| Facility | | $9,549.93 | $21,379.62 | $30,902.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $338.84 / $2,691.53 / $7,762.47
| Professional | | $338.84 | $2,691.53 | $7,762.47 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $56.23 / $42,657.95 / $42,657.95
| Facility | | $56.23 | $42,657.95 | $42,657.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $23,442.29 / $27,542.29 / $27,542.29
| Professional | | $23,442.29 | $27,542.29 | $27,542.29 |