- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $162.18 / $4,786.30 / $9,549.93
| Facility | | $162.18 | $4,786.30 | $9,549.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $72.44 / $177.83 / $602.56
| Professional | | $72.44 | $177.83 | $602.56 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $107.15 / $436.52 / $1,584.89
| Professional | 50 | $107.15 | $436.52 | $1,584.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $120.23 / $213.80 / $467.74
| Professional | | $120.23 | $213.80 | $467.74 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $120.23 / $190.55 / $436.52
| Professional | | $120.23 | $190.55 | $436.52 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $93.33 / $263.03 / $8,709.64
| Facility | | $93.33 | $263.03 | $8,709.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $102.33 / $245.47 / $457.09
| Professional | | $102.33 | $245.47 | $457.09 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $107.15 / $436.52 / $1,584.89
| Professional | 50 | $107.15 | $436.52 | $1,584.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $204.17 / $346.74 / $346.74
| Facility | | $204.17 | $346.74 | $346.74 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $85.11 / $186.21 / $436.52
| Facility | | $85.11 | $186.21 | $436.52 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $79.43 / $204.17 / $467.74
| Professional | | $79.43 | $204.17 | $467.74 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,370.32 / $8,912.51 / $11,220.18
| Facility | | $5,370.32 | $8,912.51 | $11,220.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $147.91 / $257.04 / $478.63
| Professional | | $147.91 | $257.04 | $478.63 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,454.71 / $6,918.31 / $12,589.25
| Facility | | $2,454.71 | $6,918.31 | $12,589.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $117.49 / $229.09 / $446.68
| Professional | | $117.49 | $229.09 | $446.68 |