- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $457.09 / $2,290.87 / $6,918.31
| Facility | | $457.09 | $2,290.87 | $6,918.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $52.48 / $85.11 / $165.96
| Professional | | $52.48 | $85.11 | $165.96 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $60.26 / $229.09 / $354.81
| Professional | 50 | $60.26 | $229.09 | $354.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $43.65 / $57.54 / $89.13
| Professional | | $43.65 | $57.54 | $89.13 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $91.20 / $91.20 / $91.20
| Professional | 50 | $91.20 | $91.20 | $91.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $43.65 / $79.43 / $323.59
| Facility | | $43.65 | $79.43 | $323.59 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $50.12 / $79.43 / $125.89
| Professional | | $50.12 | $79.43 | $125.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $28.18 / $34.67 / $40.74
| Facility | | $28.18 | $34.67 | $40.74 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $29.51 / $38.90 / $97.72
| Professional | | $29.51 | $38.90 | $97.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $47.86 / $426.58 / $426.58
| Facility | | $47.86 | $426.58 | $426.58 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $95.50 / $95.50 / $95.50
| Facility | | $95.50 | $95.50 | $95.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $61.66 / $109.65 / $223.87
| Professional | | $61.66 | $109.65 | $223.87 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $54.95 / $56.23 / $2,951.21
| Facility | | $54.95 | $56.23 | $2,951.21 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,148.15 / $1,148.15 / $1,148.15
| Professional | | $1,148.15 | $1,148.15 | $1,148.15 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $57.54 / $128.82 / $2,454.71
| Facility | | $57.54 | $128.82 | $2,454.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $54.95 / $91.20 / $177.83
| Professional | | $54.95 | $91.20 | $177.83 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $60.26 / $229.09 / $229.09
| Professional | 50 | $60.26 | $229.09 | $229.09 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $72.44
| Professional | | $32.36 | $33.11 | $72.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $165.96 / $177.83 / $338.84
| Professional | | $165.96 | $177.83 | $338.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $54.95 / $107.15 / $213.80
| Facility | | $54.95 | $107.15 | $213.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $61.66 / $109.65 / $218.78
| Professional | | $61.66 | $109.65 | $218.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $436.52 / $1,479.11 / $3,630.78
| Facility | | $436.52 | $1,479.11 | $3,630.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $54.95 / $87.10 / $169.82
| Professional | | $54.95 | $87.10 | $169.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $87.10 / $89.13 / $91.20
| Professional | | $87.10 | $89.13 | $91.20 |