- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $446.68 / $3,801.89 / $8,709.64
| Facility | | $446.68 | $3,801.89 | $8,709.64 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $67.61 / $2,041.74 / $4,897.79
| Facility | 50 | $67.61 | $2,041.74 | $4,897.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $275.42 / $407.38 / $1,023.29
| Professional | | $275.42 | $407.38 | $1,023.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $208.93 / $380.19 / $602.56
| Professional | | $208.93 | $380.19 | $602.56 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $389.05 / $489.78 / $912.01
| Professional | | $389.05 | $489.78 | $912.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $338.84 / $489.78 / $758.58
| Professional | | $338.84 | $489.78 | $758.58 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $295.12 / $416.87 / $660.69
| Facility | | $295.12 | $416.87 | $660.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $407.38 / $407.38 / $758.58
| Professional | | $407.38 | $407.38 | $758.58 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,754.23 / $7,244.36 / $10,715.19
| Facility | | $2,754.23 | $7,244.36 | $10,715.19 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $295.12 / $398.11 / $724.44
| Professional | | $295.12 | $398.11 | $724.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9,772.37 / $9,772.37 / $45,708.82
| Facility | | $9,772.37 | $9,772.37 | $45,708.82 |
- Facility/Professional
- Facility
- Modifier
- 52
- Typical Low / Median / Typical High
- $7,762.47 / $7,762.47 / $7,762.47
| Facility | 52 | $7,762.47 | $7,762.47 | $7,762.47 |
- Facility/Professional
- Facility
- Modifier
- 53
- Typical Low / Median / Typical High
- $1,949.84 / $1,949.84 / $1,949.84
| Facility | 53 | $1,949.84 | $1,949.84 | $1,949.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,951.21 / $2,951.21 / $2,951.21
| Professional | | $2,951.21 | $2,951.21 | $2,951.21 |