- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $67.61 / $1,288.25 / $6,606.93
| Facility | | $67.61 | $1,288.25 | $6,606.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $61.66 / $117.49 / $309.03
| Professional | | $61.66 | $117.49 | $309.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,202.26 / $2,630.27 / $5,888.44
| Facility | | $1,202.26 | $2,630.27 | $5,888.44 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $2,089.30 / $3,388.44 / $9,549.93
| Facility | 50 | $2,089.30 | $3,388.44 | $9,549.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $125.89 / $245.47 / $478.63
| Professional | | $125.89 | $245.47 | $478.63 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $186.21 / $371.54 / $724.44
| Professional | 50 | $186.21 | $371.54 | $724.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $354.81 / $501.19 / $1,202.26
| Facility | | $354.81 | $501.19 | $1,202.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $144.54 / $288.40 / $562.34
| Professional | | $144.54 | $288.40 | $562.34 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $380.19 / $478.63 / $933.25
| Facility | | $380.19 | $478.63 | $933.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $151.36 / $275.42 / $467.74
| Professional | | $151.36 | $275.42 | $467.74 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $85.11 / $257.04 / $2,238.72
| Facility | | $85.11 | $257.04 | $2,238.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $120.23 / $234.42 / $1,230.27
| Professional | | $120.23 | $234.42 | $1,230.27 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $346.74 / $346.74 / $354.81
| Professional | 50 | $346.74 | $346.74 | $354.81 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,174.90 / $2,290.87 / $5,370.32
| Facility | | $1,174.90 | $2,290.87 | $5,370.32 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $83.18 / $173.78 / $389.05
| Professional | | $83.18 | $173.78 | $389.05 |