- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $134.90 / $1,778.28 / $8,511.38
| Facility | | $134.90 | $1,778.28 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $67.61 / $144.54 / $398.11
| Professional | | $67.61 | $144.54 | $398.11 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $208.93 / $338.84 / $1,230.27
| Professional | 50 | $208.93 | $338.84 | $1,230.27 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $109.65 / $114.82 / $128.82
| Professional | | $109.65 | $114.82 | $128.82 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,445.44 / $1,862.09 / $3,715.35
| Facility | | $1,445.44 | $1,862.09 | $3,715.35 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $2,187.76 / $2,754.23 / $5,623.41
| Facility | 50 | $2,187.76 | $2,754.23 | $5,623.41 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $81.28 / $173.78 / $354.81
| Professional | | $81.28 | $173.78 | $354.81 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $239.88 / $467.74 / $562.34
| Facility | | $239.88 | $467.74 | $562.34 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $83.18 / $173.78 / $389.05
| Professional | | $83.18 | $173.78 | $389.05 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $87.10 / $169.82 / $398.11
| Facility | | $87.10 | $169.82 | $398.11 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $1,737.80 / $2,570.40 / $5,011.87
| Facility | 50 | $1,737.80 | $2,570.40 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $87.10 / $169.82 / $346.74
| Professional | | $87.10 | $169.82 | $346.74 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $67.61
| Professional | | $32.36 | $33.11 | $67.61 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $169.82 / $257.04 / $309.03
| Facility | | $169.82 | $257.04 | $309.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $169.82 / $169.82 / $218.78
| Facility | | $169.82 | $169.82 | $218.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $97.72 / $218.78 / $389.05
| Professional | | $97.72 | $218.78 | $389.05 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,318.26 / $1,905.46 / $3,715.35
| Facility | | $1,318.26 | $1,905.46 | $3,715.35 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $1,995.26 / $2,884.03 / $5,623.41
| Facility | 50 | $1,995.26 | $2,884.03 | $5,623.41 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $81.28 / $173.78 / $338.84
| Professional | | $81.28 | $173.78 | $338.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $645.65 / $2,238.72 / $4,570.88
| Facility | | $645.65 | $2,238.72 | $4,570.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $75.86 / $158.49 / $316.23
| Professional | | $75.86 | $158.49 | $316.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $70.79 / $134.90 / $251.19
| Professional | | $70.79 | $134.90 | $251.19 |