- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $602.56 / $5,370.32
| Facility | | $32.36 | $602.56 | $5,370.32 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $23.99 / $83.18 / $371.54
| Professional | | $23.99 | $83.18 | $371.54 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $208.93 / $489.78 / $489.78
| Professional | 50 | $208.93 | $489.78 | $489.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $53.70 / $77.62 / $295.12
| Professional | | $53.70 | $77.62 | $295.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.70 / $54.95 / $588.84
| Professional | | $25.70 | $54.95 | $588.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $46.77 / $223.87 / $2,951.21
| Facility | | $46.77 | $223.87 | $2,951.21 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $35.48 / $173.78 / $1,949.84
| Professional | | $35.48 | $173.78 | $1,949.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $61.66 / $83.18 / $478.63
| Professional | | $61.66 | $83.18 | $478.63 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $83.18 / $295.12 / $309.03
| Professional | | $83.18 | $295.12 | $309.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $22.91 / $41.69 / $74.13
| Professional | | $22.91 | $41.69 | $74.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,288.25 / $2,238.72 / $5,128.61
| Facility | | $1,288.25 | $2,238.72 | $5,128.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $26.30 / $67.61 / $269.15
| Professional | | $26.30 | $67.61 | $269.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $46.77 / $54.95 / $75.86
| Professional | | $46.77 | $54.95 | $75.86 |