- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $630.96 / $4,073.80 / $12,302.69
| Facility | | $630.96 | $4,073.80 | $12,302.69 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $4,073.80 / $4,466.84 / $31,622.78
| Facility | 50 | $4,073.80 | $4,466.84 | $31,622.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $389.05 / $537.03 / $1,479.11
| Professional | | $389.05 | $537.03 | $1,479.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,019.95 / $4,570.88 / $19,498.45
| Facility | | $3,019.95 | $4,570.88 | $19,498.45 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,456.54 / $6,606.93 / $57,543.99
| Facility | | $6,456.54 | $6,606.93 | $57,543.99 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $457.09 / $660.69 / $933.25
| Professional | | $457.09 | $660.69 | $933.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $398.11 / $562.34 / $912.01
| Professional | | $398.11 | $562.34 | $912.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $891.25 / $891.25 / $954.99
| Professional | | $891.25 | $891.25 | $954.99 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $426.58 / $676.08 / $977.24
| Professional | | $426.58 | $676.08 | $977.24 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,011.87 / $10,715.19 / $22,908.68
| Facility | | $5,011.87 | $10,715.19 | $22,908.68 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $21,877.62 / $21,877.62 / $21,877.62
| Facility | 50 | $21,877.62 | $21,877.62 | $21,877.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $446.68 / $467.74 / $575.44
| Professional | | $446.68 | $467.74 | $575.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,691.53 / $3,801.89 / $19,498.45
| Facility | | $2,691.53 | $3,801.89 | $19,498.45 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $537.03 / $1,659.59 / $8,709.64
| Facility | | $537.03 | $1,659.59 | $8,709.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $407.38 / $549.54 / $1,148.15
| Professional | | $407.38 | $549.54 | $1,148.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $398.11 / $831.76 / $1,148.15
| Professional | | $398.11 | $831.76 | $1,148.15 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $407.38 / $446.68 / $676.08
| Facility | | $407.38 | $446.68 | $676.08 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $309.03 / $416.87 / $549.54
| Professional | | $309.03 | $416.87 | $549.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,659.59 / $3,981.07 / $12,589.25
| Facility | | $1,659.59 | $3,981.07 | $12,589.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $389.05 / $537.03 / $933.25
| Professional | | $389.05 | $537.03 | $933.25 |