- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,202.26 / $3,981.07 / $8,709.64
| Facility | | $1,202.26 | $3,981.07 | $8,709.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $79.43 / $199.53 / $323.59
| Professional | | $79.43 | $199.53 | $323.59 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $288.40 / $309.03 / $380.19
| Professional | 50 | $288.40 | $309.03 | $380.19 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,454.71 / $3,467.37 / $8,511.38
| Facility | | $2,454.71 | $3,467.37 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $83.18 / $114.82 / $199.53
| Professional | | $83.18 | $114.82 | $199.53 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $81.28 / $125.89 / $354.81
| Professional | 50 | $81.28 | $125.89 | $354.81 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $141.25 / $141.25 / $1,659.59
| Facility | | $141.25 | $141.25 | $1,659.59 |
- Facility/Professional
- Facility
- Modifier
- 52
- Typical Low / Median / Typical High
- $112.20 / $112.20 / $112.20
| Facility | 52 | $112.20 | $112.20 | $112.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $95.50 / $223.87 / $389.05
| Professional | | $95.50 | $223.87 | $389.05 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $74.13 / $245.47 / $1,548.82
| Professional | | $74.13 | $245.47 | $1,548.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $74.13 / $218.78 / $245.47
| Professional | | $74.13 | $218.78 | $245.47 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,174.90 / $2,290.87 / $3,890.45
| Facility | | $1,174.90 | $2,290.87 | $3,890.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $97.72 / $190.55 / $380.19
| Professional | | $97.72 | $190.55 | $380.19 |