- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $223.87 / $3,630.78 / $7,079.46
| Facility | | $223.87 | $3,630.78 | $7,079.46 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $4,168.69 / $4,168.69 / $4,168.69
| Facility | 50 | $4,168.69 | $4,168.69 | $4,168.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $51.29 / $117.49 / $316.23
| Professional | | $51.29 | $117.49 | $316.23 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $144.54 / $346.74 / $933.25
| Professional | 50 | $144.54 | $346.74 | $933.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,137.96 / $3,162.28 / $11,748.98
| Facility | | $2,137.96 | $3,162.28 | $11,748.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $70.79 / $128.82 / $234.42
| Professional | | $70.79 | $128.82 | $234.42 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $104.71 / $190.55 / $288.40
| Professional | 50 | $104.71 | $190.55 | $288.40 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $251.19 / $489.78 / $549.54
| Facility | | $251.19 | $489.78 | $549.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $74.13 / $154.88 / $302.00
| Professional | | $74.13 | $154.88 | $302.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $147.91 / $194.98 / $245.47
| Professional | | $147.91 | $194.98 | $245.47 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $245.47 / $245.47 / $295.12
| Facility | | $245.47 | $245.47 | $295.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $50.12 / $81.28 / $165.96
| Professional | | $50.12 | $81.28 | $165.96 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $38.02 / $38.02 / $38.02
| Professional | 50 | $38.02 | $38.02 | $38.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,288.25 / $3,981.07 / $7,079.46
| Facility | | $1,288.25 | $3,981.07 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $53.70 / $114.82 / $275.42
| Professional | | $53.70 | $114.82 | $275.42 |