- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $831.76 / $5,370.32 / $20,417.38
| Facility | | $831.76 | $5,370.32 | $20,417.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $295.12 / $1,513.56 / $6,165.95
| Professional | | $295.12 | $1,513.56 | $6,165.95 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $501.19 / $2,238.72 / $2,238.72
| Professional | 50 | $501.19 | $2,238.72 | $2,238.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $20,417.38 / $21,379.62 / $57,543.99
| Facility | | $20,417.38 | $21,379.62 | $57,543.99 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4,365.16 / $6,165.95 / $7,762.47
| Professional | | $4,365.16 | $6,165.95 | $7,762.47 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $3,090.30 / $8,317.64 / $11,220.18
| Professional | 50 | $3,090.30 | $8,317.64 | $11,220.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $323.59 / $602.56 / $6,165.95
| Professional | | $323.59 | $602.56 | $6,165.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5,495.41 / $5,495.41 / $5,623.41
| Professional | | $5,495.41 | $5,495.41 | $5,623.41 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $407.38 / $4,265.80 / $7,079.46
| Professional | | $407.38 | $4,265.80 | $7,079.46 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,128.61 / $23,988.33 / $40,738.03
| Facility | | $5,128.61 | $23,988.33 | $40,738.03 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $6,025.60 / $6,025.60 / $52,480.75
| Facility | 50 | $6,025.60 | $6,025.60 | $52,480.75 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $323.59 / $338.84 / $3,630.78
| Professional | | $323.59 | $338.84 | $3,630.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $660.69 / $3,981.07 / $14,454.40
| Facility | | $660.69 | $3,981.07 | $14,454.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $323.59 / $1,584.89 / $6,760.83
| Professional | | $323.59 | $1,584.89 | $6,760.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $354.81 / $363.08 / $457.09
| Professional | | $354.81 | $363.08 | $457.09 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $295.12 / $1,479.11 / $4,265.80
| Facility | | $295.12 | $1,479.11 | $4,265.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $295.12 / $1,479.11 / $4,265.80
| Professional | | $295.12 | $1,479.11 | $4,265.80 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,630.78 / $10,964.78 / $37,153.52
| Facility | | $3,630.78 | $10,964.78 | $37,153.52 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $316.23 / $2,137.96 / $5,888.44
| Professional | | $316.23 | $2,137.96 | $5,888.44 |