- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $138.04 / $851.14 / $3,890.45
| Facility | | $138.04 | $851.14 | $3,890.45 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $3,981.07 / $3,981.07 / $5,888.44
| Facility | 50 | $3,981.07 | $3,981.07 | $5,888.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $97.72 / $338.84 / $851.14
| Professional | | $97.72 | $338.84 | $851.14 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $141.25 / $446.68 / $3,019.95
| Professional | 50 | $141.25 | $446.68 | $3,019.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $107.15 / $107.15 / $107.15
| Professional | | $107.15 | $107.15 | $107.15 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,479.11 / $2,398.83 / $4,365.16
| Facility | | $1,479.11 | $2,398.83 | $4,365.16 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $100.00 / $363.08 / $524.81
| Professional | | $100.00 | $363.08 | $524.81 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $147.91 / $549.54 / $758.58
| Professional | 50 | $147.91 | $549.54 | $758.58 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $89.13 / $123.03 / $147.91
| Facility | | $89.13 | $123.03 | $147.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $83.18 / $123.03 / $151.36
| Professional | | $83.18 | $123.03 | $151.36 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $34.67 / $165.96 / $165.96
| Facility | | $34.67 | $165.96 | $165.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $109.65 / $549.54 / $2,691.53
| Professional | | $109.65 | $549.54 | $2,691.53 |
- 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
- $416.87 / $1,621.81 / $3,467.37
| Facility | | $416.87 | $1,621.81 | $3,467.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $102.33 / $380.19 / $851.14
| Professional | | $102.33 | $380.19 | $851.14 |