- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,691.53 / $10,471.29 / $21,379.62
| Facility | | $2,691.53 | $10,471.29 | $21,379.62 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $32,359.37 / $32,359.37 / $32,359.37
| Facility | 50 | $32,359.37 | $32,359.37 | $32,359.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $562.34 / $851.14 / $1,698.24
| Professional | | $562.34 | $851.14 | $1,698.24 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $549.54 / $707.95 / $1,047.13
| Professional | | $549.54 | $707.95 | $1,047.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,380.38 / $6,456.54 / $14,125.38
| Facility | | $1,380.38 | $6,456.54 | $14,125.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $645.65 / $954.99 / $1,548.82
| Professional | | $645.65 | $954.99 | $1,548.82 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $691.83 / $776.25 / $1,122.02
| Facility | | $691.83 | $776.25 | $1,122.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $912.01 / $977.24 / $1,621.81
| Professional | | $912.01 | $977.24 | $1,621.81 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12,022.64 / $18,197.01 / $23,442.29
| Facility | | $12,022.64 | $18,197.01 | $23,442.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $616.60 / $1,000.00 / $1,698.24
| Professional | | $616.60 | $1,000.00 | $1,698.24 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $537.03 / $851.14 / $1,479.11
| Professional | | $537.03 | $851.14 | $1,479.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,623.41 / $7,943.28 / $7,943.28
| Facility | | $5,623.41 | $7,943.28 | $7,943.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,096.48 / $1,348.96 / $1,584.89
| Professional | | $1,096.48 | $1,348.96 | $1,584.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,995.26 / $7,079.46 / $17,378.01
| Facility | | $1,995.26 | $7,079.46 | $17,378.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $588.84 / $912.01 / $1,584.89
| Professional | | $588.84 | $912.01 | $1,584.89 |