- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,265.80 / $7,079.46 / $14,454.40
| Facility | | $4,265.80 | $7,079.46 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $8,511.38 / $10,471.29 / $10,964.78
| Facility | 50 | $8,511.38 | $10,471.29 | $10,964.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $407.38 / $912.01 / $1,737.80
| Professional | | $407.38 | $912.01 | $1,737.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $416.87 / $676.08 / $912.01
| Professional | | $416.87 | $676.08 | $912.01 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8,317.64 / $10,471.29 / $20,892.96
| Facility | | $8,317.64 | $10,471.29 | $20,892.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $363.08 / $616.60 / $912.01
| Professional | | $363.08 | $616.60 | $912.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $446.68 / $933.25 / $1,258.93
| Professional | | $446.68 | $933.25 | $1,258.93 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $645.65 / $6,309.57 / $10,964.78
| Facility | | $645.65 | $6,309.57 | $10,964.78 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $2,290.87 / $8,128.31 / $14,791.08
| Facility | 50 | $2,290.87 | $8,128.31 | $14,791.08 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $537.03 / $831.76 / $1,148.15
| Professional | | $537.03 | $831.76 | $1,148.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $891.25 / $977.24 / $1,258.93
| Professional | | $891.25 | $977.24 | $1,258.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $891.25 / $891.25 / $891.25
| Professional | | $891.25 | $891.25 | $891.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,025.60 / $7,079.46 / $7,079.46
| Facility | | $6,025.60 | $7,079.46 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $457.09 / $1,023.29
| Professional | | $5.01 | $457.09 | $1,023.29 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,309.57 / $6,918.31 / $9,120.11
| Facility | | $6,309.57 | $6,918.31 | $9,120.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $537.03 / $794.33 / $1,047.13
| Professional | | $537.03 | $794.33 | $1,047.13 |