- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $426.58 / $1,995.26 / $8,128.31
| Facility | | $426.58 | $1,995.26 | $8,128.31 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $4,073.80 / $10,471.29 / $13,803.84
| Facility | 50 | $4,073.80 | $10,471.29 | $13,803.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $141.25 / $251.19 / $676.08
| Professional | | $141.25 | $251.19 | $676.08 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $162.18 / $346.74 / $1,905.46
| Professional | 50 | $162.18 | $346.74 | $1,905.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $81.28 / $158.49 / $204.17
| Professional | | $81.28 | $158.49 | $204.17 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $128.82 / $128.82 / $239.88
| Professional | 50 | $128.82 | $128.82 | $239.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,884.03 / $5,370.32 / $7,585.78
| Facility | | $2,884.03 | $5,370.32 | $7,585.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $181.97 / $302.00 / $630.96
| Professional | | $181.97 | $302.00 | $630.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $39.81 / $2,951.21 / $2,951.21
| Facility | | $39.81 | $2,951.21 | $2,951.21 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $154.88 / $275.42 / $691.83
| Professional | | $154.88 | $275.42 | $691.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $831.76 / $2,818.38 / $7,762.47
| Facility | | $831.76 | $2,818.38 | $7,762.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $144.54 / $371.54 / $724.44
| Professional | | $144.54 | $371.54 | $724.44 |