- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $83.18 / $1,288.25 / $6,025.60
| Facility | | $83.18 | $1,288.25 | $6,025.60 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $0.55 / $1,380.38 / $6,606.93
| Facility | 50 | $0.55 | $1,380.38 | $6,606.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $40.74 / $89.13 / $218.78
| Professional | | $40.74 | $89.13 | $218.78 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $60.26 / $173.78 / $549.54
| Professional | 50 | $60.26 | $173.78 | $549.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $34.67 / $64.57 / $144.54
| Professional | | $34.67 | $64.57 | $144.54 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $38.02 / $57.54 / $194.98
| Professional | 50 | $38.02 | $57.54 | $194.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $51.29 / $1,445.44 / $9,772.37
| Facility | | $51.29 | $1,445.44 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $40.74 / $74.13 / $102.33
| Professional | | $40.74 | $74.13 | $102.33 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $44.67 / $53.70 / $323.59
| Facility | | $44.67 | $53.70 | $323.59 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $43.65 / $79.43 / $151.36
| Professional | | $43.65 | $79.43 | $151.36 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,290.87 / $3,388.44 / $7,585.78
| Facility | | $2,290.87 | $3,388.44 | $7,585.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $54.95 / $67.61 / $107.15
| Professional | | $54.95 | $67.61 | $107.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $102.33
| Professional | | $32.36 | $33.11 | $102.33 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $575.44 / $2,290.87 / $5,011.87
| Facility | | $575.44 | $2,290.87 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $38.02 / $70.79 / $131.83
| Professional | | $38.02 | $70.79 | $131.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $31.62 / $56.23 / $83.18
| Professional | | $31.62 | $56.23 | $83.18 |