- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $588.84 / $3,801.89 / $9,549.93
| Facility | | $588.84 | $3,801.89 | $9,549.93 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $1,778.28 / $5,370.32 / $10,964.78
| Facility | 50 | $1,778.28 | $5,370.32 | $10,964.78 |
- Facility/Professional
- Facility
- Modifier
- 52
- Typical Low / Median / Typical High
- $1,174.90 / $1,174.90 / $2,630.27
| Facility | 52 | $1,174.90 | $1,174.90 | $2,630.27 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $144.54 / $302.00 / $891.25
| Professional | | $144.54 | $302.00 | $891.25 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $141.25 / $489.78 / $1,862.09
| Professional | 50 | $141.25 | $489.78 | $1,862.09 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,454.71 / $6,165.95 / $14,125.38
| Facility | | $2,454.71 | $6,165.95 | $14,125.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $169.82 / $380.19 / $933.25
| Professional | | $169.82 | $380.19 | $933.25 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $251.19 / $562.34 / $1,348.96
| Professional | 50 | $251.19 | $562.34 | $1,348.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $870.96 / $1,995.26 / $12,589.25
| Facility | | $870.96 | $1,995.26 | $12,589.25 |
- Facility/Professional
- Facility
- Modifier
- 22
- Typical Low / Median / Typical High
- $316.23 / $316.23 / $316.23
| Facility | 22 | $316.23 | $316.23 | $316.23 |
- Facility/Professional
- Facility
- Modifier
- 52
- Typical Low / Median / Typical High
- $208.93 / $208.93 / $208.93
| Facility | 52 | $208.93 | $208.93 | $208.93 |
- Facility/Professional
- Facility
- Modifier
- 53
- Typical Low / Median / Typical High
- $52.48 / $52.48 / $52.48
| Facility | 53 | $52.48 | $52.48 | $52.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $169.82 / $416.87 / $1,023.29
| Professional | | $169.82 | $416.87 | $1,023.29 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,737.80 / $4,168.69 / $9,772.37
| Facility | | $1,737.80 | $4,168.69 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $151.36 / $389.05 / $851.14
| Professional | | $151.36 | $389.05 | $851.14 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $616.60 / $616.60 / $616.60
| Professional | 50 | $616.60 | $616.60 | $616.60 |