- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,023.29 / $10,964.78 / $20,417.38
| Facility | | $1,023.29 | $10,964.78 | $20,417.38 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $12,022.64 / $17,782.79 / $20,417.38
| Facility | 50 | $12,022.64 | $17,782.79 | $20,417.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $398.11 / $588.84 / $1,862.09
| Professional | | $398.11 | $588.84 | $1,862.09 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $446.68 / $851.14 / $1,174.90
| Professional | | $446.68 | $851.14 | $1,174.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $575.44 / $776.25 / $1,023.29
| Professional | | $575.44 | $776.25 | $1,023.29 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $537.03 / $8,709.64 / $20,417.38
| Facility | | $537.03 | $8,709.64 | $20,417.38 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $416.87 / $17,782.79 / $20,417.38
| Facility | 50 | $416.87 | $17,782.79 | $20,417.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $501.19 / $741.31 / $1,318.26
| Professional | | $501.19 | $741.31 | $1,318.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $512.86 / $794.33 / $812.83
| Facility | | $512.86 | $794.33 | $812.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $436.52 / $549.54 / $1,047.13
| Facility | | $436.52 | $549.54 | $1,047.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $79.43 / $794.33 / $1,122.02
| Professional | | $79.43 | $794.33 | $1,122.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12,022.64 / $16,595.87 / $20,417.38
| Facility | | $12,022.64 | $16,595.87 | $20,417.38 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $17,782.79 / $25,118.86 / $30,199.52
| Facility | 50 | $17,782.79 | $25,118.86 | $30,199.52 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $776.25 / $977.24 / $1,230.27
| Professional | | $776.25 | $977.24 | $1,230.27 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,011.87 / $16,218.10 / $23,442.29
| Facility | | $5,011.87 | $16,218.10 | $23,442.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $562.34 / $794.33 / $1,148.15
| Professional | | $562.34 | $794.33 | $1,148.15 |