- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $234.42 / $501.19 / $6,606.93
| Facility | | $234.42 | $501.19 | $6,606.93 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $851.14 / $851.14 / $4,570.88
| Facility | 50 | $851.14 | $851.14 | $4,570.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $102.33 / $213.80 / $1,023.29
| Professional | | $102.33 | $213.80 | $1,023.29 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $162.18 / $416.87 / $1,698.24
| Professional | 50 | $162.18 | $416.87 | $1,698.24 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $549.54 / $549.54 / $549.54
| Facility | | $549.54 | $549.54 | $549.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $154.88 / $269.15 / $512.86
| Professional | | $154.88 | $269.15 | $512.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $186.21 / $275.42 / $512.86
| Professional | | $186.21 | $275.42 | $512.86 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $128.82 / $257.04 / $467.74
| Facility | | $128.82 | $257.04 | $467.74 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $851.14 / $851.14 / $4,570.88
| Facility | 50 | $851.14 | $851.14 | $4,570.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $165.96 / $302.00 / $489.78
| Professional | | $165.96 | $302.00 | $489.78 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $158.49 / $346.74 / $933.25
| Professional | 50 | $158.49 | $346.74 | $933.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $229.09 / $363.08 / $389.05
| Facility | | $229.09 | $363.08 | $389.05 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $128.82 / $239.88 / $436.52
| Facility | | $128.82 | $239.88 | $436.52 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $79.43 / $263.03 / $478.63
| Professional | | $79.43 | $263.03 | $478.63 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,290.87 / $3,162.28 / $3,890.45
| Facility | | $2,290.87 | $3,162.28 | $3,890.45 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $3,388.44 / $4,786.30 / $5,754.40
| Facility | 50 | $3,388.44 | $4,786.30 | $5,754.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $199.53 / $316.23 / $537.03
| Professional | | $199.53 | $316.23 | $537.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,548.82 / $2,951.21 / $4,897.79
| Facility | | $1,548.82 | $2,951.21 | $4,897.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $154.88 / $269.15 / $457.09
| Professional | | $154.88 | $269.15 | $457.09 |