- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $316.23 / $5,495.41 / $10,232.93
| Facility | | $316.23 | $5,495.41 | $10,232.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $74.13 / $151.36 / $302.00
| Professional | | $74.13 | $151.36 | $302.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,445.44 / $3,630.78 / $7,413.10
| Facility | | $1,445.44 | $3,630.78 | $7,413.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $138.04 / $275.42 / $346.74
| Professional | | $138.04 | $275.42 | $346.74 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $218.78 / $478.63 / $524.81
| Professional | 50 | $218.78 | $478.63 | $524.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $97.72 / $194.98 / $302.00
| Professional | | $97.72 | $194.98 | $302.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $109.65 / $316.23 / $7,079.46
| Facility | | $109.65 | $316.23 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $81.28 / $169.82 / $354.81
| Professional | | $81.28 | $169.82 | $354.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $32.36 / $33.11
| Professional | | $32.36 | $32.36 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,570.88 / $6,456.54 / $8,912.51
| Facility | | $4,570.88 | $6,456.54 | $8,912.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $114.82 / $147.91 / $288.40
| Professional | | $114.82 | $147.91 | $288.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $120.23 / $165.96 / $5,248.07
| Professional | | $120.23 | $165.96 | $5,248.07 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,467.37 / $6,165.95 / $7,762.47
| Facility | | $3,467.37 | $6,165.95 | $7,762.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $85.11 / $169.82 / $288.40
| Professional | | $85.11 | $169.82 | $288.40 |