- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $416.87 / $3,311.31 / $6,760.83
| Facility | | $416.87 | $3,311.31 | $6,760.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $302.00 / $1,000.00 / $7,585.78
| Professional | | $302.00 | $1,000.00 | $7,585.78 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $512.86 / $512.86 / $870.96
| Professional | 50 | $512.86 | $512.86 | $870.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12,882.50 / $17,378.01 / $29,512.09
| Facility | | $12,882.50 | $17,378.01 | $29,512.09 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $501.19 / $3,548.13 / $14,791.08
| Professional | | $501.19 | $3,548.13 | $14,791.08 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $812.83 / $5,248.07 / $22,387.21
| Professional | 50 | $812.83 | $5,248.07 | $22,387.21 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9,332.54 / $10,715.19 / $17,378.01
| Facility | | $9,332.54 | $10,715.19 | $17,378.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $501.19 / $1,023.29 / $12,022.64
| Professional | | $501.19 | $1,023.29 | $12,022.64 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $363.08 / $6,760.83 / $13,489.63
| Facility | | $363.08 | $6,760.83 | $13,489.63 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $691.83 / $1,000.00 / $9,772.37
| Professional | | $691.83 | $1,000.00 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $1,023.29 / $1,479.11 / $14,454.40
| Professional | 50 | $1,023.29 | $1,479.11 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $407.38 / $10,715.19 / $21,379.62
| Facility | | $407.38 | $10,715.19 | $21,379.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,801.89 / $7,943.28 / $18,620.87
| Professional | | $3,801.89 | $7,943.28 | $18,620.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $954.99
| Professional | | $32.36 | $33.11 | $954.99 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11,748.98 / $12,882.50 / $27,542.29
| Facility | | $11,748.98 | $12,882.50 | $27,542.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $851.14 / $4,786.30 / $14,125.38
| Professional | | $851.14 | $4,786.30 | $14,125.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $616.60 / $3,630.78 / $11,220.18
| Professional | | $616.60 | $3,630.78 | $11,220.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $27,542.29 / $27,542.29 / $40,738.03
| Facility | | $27,542.29 | $27,542.29 | $40,738.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $501.19 / $7,079.46 / $23,442.29
| Professional | | $501.19 | $7,079.46 | $23,442.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,513.56 / $1,513.56 / $19,054.61
| Professional | | $1,513.56 | $1,513.56 | $19,054.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,621.81 / $17,378.01 / $23,988.33
| Professional | | $1,621.81 | $17,378.01 | $23,988.33 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9,549.93 / $17,378.01 / $23,442.29
| Facility | | $9,549.93 | $17,378.01 | $23,442.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $416.87 / $2,187.76 / $13,489.63
| Professional | | $416.87 | $2,187.76 | $13,489.63 |