- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $257.04 / $2,290.87 / $6,918.31
| Facility | | $257.04 | $2,290.87 | $6,918.31 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $1,819.70 / $5,370.32 / $18,197.01
| Facility | 50 | $1,819.70 | $5,370.32 | $18,197.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $151.36 / $380.19 / $912.01
| Professional | | $151.36 | $380.19 | $912.01 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $218.78 / $870.96 / $3,467.37
| Professional | 50 | $218.78 | $870.96 | $3,467.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $144.54 / $177.83 / $223.87
| Professional | | $144.54 | $177.83 | $223.87 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $213.80 / $269.15 / $275.42
| Professional | 50 | $213.80 | $269.15 | $275.42 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,584.89 / $4,265.80 / $15,848.93
| Facility | | $1,584.89 | $4,265.80 | $15,848.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $144.54 / $436.52 / $1,023.29
| Professional | | $144.54 | $436.52 | $1,023.29 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $218.78 / $660.69 / $1,513.56
| Professional | 50 | $218.78 | $660.69 | $1,513.56 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $141.25 / $199.53 / $269.15
| Facility | | $141.25 | $199.53 | $269.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $173.78 / $346.74 / $478.63
| Professional | | $173.78 | $346.74 | $478.63 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $263.03 / $263.03 / $1,659.59
| Facility | | $263.03 | $263.03 | $1,659.59 |
- 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
- $173.78 / $446.68 / $4,897.79
| Professional | | $173.78 | $446.68 | $4,897.79 |
- 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
- $602.56 / $3,467.37 / $6,456.54
| Facility | | $602.56 | $3,467.37 | $6,456.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $154.88 / $363.08 / $794.33
| Professional | | $154.88 | $363.08 | $794.33 |