- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $977.24 / $4,365.16 / $6,309.57
| Facility | | $977.24 | $4,365.16 | $6,309.57 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $1,548.82 / $4,466.84 / $6,918.31
| Facility | 50 | $1,548.82 | $4,466.84 | $6,918.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $107.15 / $263.03 / $1,230.27
| Professional | | $107.15 | $263.03 | $1,230.27 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $169.82 / $436.52 / $1,513.56
| Professional | 50 | $169.82 | $436.52 | $1,513.56 |
- Facility/Professional
- Professional
- Modifier
- 53
- Typical Low / Median / Typical High
- $36.31 / $36.31 / $37.15
| Professional | 53 | $36.31 | $36.31 | $37.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $123.03 / $123.03 / $199.53
| Professional | | $123.03 | $123.03 | $199.53 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $147.91 / $147.91 / $426.58
| Professional | 50 | $147.91 | $147.91 | $426.58 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,621.81 / $5,011.87 / $5,754.40
| Facility | | $1,621.81 | $5,011.87 | $5,754.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $97.72 / $426.58 / $794.33
| Professional | | $97.72 | $426.58 | $794.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $114.82 / $245.47 / $724.44
| Professional | | $114.82 | $245.47 | $724.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $269.15 / $346.74 / $1,621.81
| Professional | | $269.15 | $346.74 | $1,621.81 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,819.70 / $2,884.03 / $4,570.88
| Facility | | $1,819.70 | $2,884.03 | $4,570.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $89.13 / $234.42 / $741.31
| Professional | | $89.13 | $234.42 | $741.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,819.70 / $3,548.13 / $6,606.93
| Facility | | $1,819.70 | $3,548.13 | $6,606.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $81.28 / $213.80 / $501.19
| Professional | | $81.28 | $213.80 | $501.19 |