- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $281.84 / $1,202.26 / $5,248.07
| Facility | | $281.84 | $1,202.26 | $5,248.07 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $724.44 / $1,479.11 / $3,162.28
| Facility | 50 | $724.44 | $1,479.11 | $3,162.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $39.81 / $77.62 / $186.21
| Professional | | $39.81 | $77.62 | $186.21 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $57.54 / $134.90 / $489.78
| Professional | 50 | $57.54 | $134.90 | $489.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $35.48 / $48.98 / $109.65
| Professional | | $35.48 | $48.98 | $109.65 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $40.74 / $114.82 / $138.04
| Professional | 50 | $40.74 | $114.82 | $138.04 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $46.77 / $70.79 / $295.12
| Facility | | $46.77 | $70.79 | $295.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $36.31 / $60.26 / $93.33
| Professional | | $36.31 | $60.26 | $93.33 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $36.31 / $36.31 / $41.69
| Facility | | $36.31 | $36.31 | $41.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $28.18 / $69.18 / $120.23
| Professional | | $28.18 | $69.18 | $120.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $38.02 / $602.56 / $602.56
| Facility | | $38.02 | $602.56 | $602.56 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $70.79 / $70.79 / $70.79
| Facility | | $70.79 | $70.79 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $45.71 / $89.13 / $162.18
| Professional | | $45.71 | $89.13 | $162.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,951.21 / $15,135.61 / $15,135.61
| Facility | | $2,951.21 | $15,135.61 | $15,135.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,348.96 / $1,348.96 / $1,348.96
| Professional | | $1,348.96 | $1,348.96 | $1,348.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $46.77 / $114.82 / $2,630.27
| Facility | | $46.77 | $114.82 | $2,630.27 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $724.44 / $1,479.11 / $3,162.28
| Facility | 50 | $724.44 | $1,479.11 | $3,162.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $40.74 / $77.62 / $158.49
| Professional | | $40.74 | $77.62 | $158.49 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $57.54 / $134.90 / $489.78
| Professional | 50 | $57.54 | $134.90 | $489.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $63.10
| Professional | | $32.36 | $33.11 | $63.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $128.82 / $144.54 / $302.00
| Professional | | $128.82 | $144.54 | $302.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $41.69 / $93.33 / $162.18
| Facility | | $41.69 | $93.33 | $162.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $46.77 / $87.10 / $162.18
| Professional | | $46.77 | $87.10 | $162.18 |
- 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
- $39.81 / $72.44 / $125.89
| Professional | | $39.81 | $72.44 | $125.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $77.62 / $79.43 / $81.28
| Professional | | $77.62 | $79.43 | $81.28 |