- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $812.83 / $4,570.88 / $11,748.98
| Facility | | $812.83 | $4,570.88 | $11,748.98 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $537.03 / $4,168.69 / $11,748.98
| Facility | 50 | $537.03 | $4,168.69 | $11,748.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $269.15 / $489.78 / $1,023.29
| Professional | | $269.15 | $489.78 | $1,023.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $245.47 / $331.13 / $501.19
| Professional | | $245.47 | $331.13 | $501.19 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $870.96 / $4,073.80 / $12,302.69
| Facility | | $870.96 | $4,073.80 | $12,302.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $380.19 / $457.09 / $524.81
| Professional | | $380.19 | $457.09 | $524.81 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,548.82 / $13,182.57 / $53,703.18
| Facility | | $1,548.82 | $13,182.57 | $53,703.18 |
- Facility/Professional
- Facility
- Modifier
- 22
- Typical Low / Median / Typical High
- $912.01 / $912.01 / $912.01
| Facility | 22 | $912.01 | $912.01 | $912.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $371.54 / $575.44 / $912.01
| Professional | | $371.54 | $575.44 | $912.01 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,918.31 / $13,489.63 / $23,988.33
| Facility | | $6,918.31 | $13,489.63 | $23,988.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $316.23 / $338.84 / $436.52
| Professional | | $316.23 | $338.84 | $436.52 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $616.60
| Professional | | $32.36 | $33.11 | $616.60 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,737.80 / $5,495.41 / $9,772.37
| Facility | | $1,737.80 | $5,495.41 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $354.81 / $512.86 / $954.99
| Professional | | $354.81 | $512.86 | $954.99 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $346.74 / $346.74 / $478.63
| Professional | | $346.74 | $346.74 | $478.63 |