- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $87.10 / $1,905.46 / $6,456.54
| Facility | | $87.10 | $1,905.46 | $6,456.54 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $549.54 / $1,258.93 / $3,235.94
| Facility | 50 | $549.54 | $1,258.93 | $3,235.94 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $47.86 / $85.11 / $199.53
| Professional | | $47.86 | $85.11 | $199.53 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $72.44 / $125.89 / $295.12
| Professional | 50 | $72.44 | $125.89 | $295.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $42.66 / $83.18 / $93.33
| Professional | | $42.66 | $83.18 | $93.33 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $61.66 / $81.28 / $138.04
| Professional | 50 | $61.66 | $81.28 | $138.04 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $323.59 / $1,047.13 / $1,122.02
| Facility | | $323.59 | $1,047.13 | $1,122.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $97.72 / $97.72 / $147.91
| Professional | | $97.72 | $97.72 | $147.91 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $630.96 / $630.96 / $630.96
| Facility | | $630.96 | $630.96 | $630.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $58.88 / $97.72 / $154.88
| Professional | | $58.88 | $97.72 | $154.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $56.23 / $123.03 / $741.31
| Facility | | $56.23 | $123.03 | $741.31 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $1,621.81 / $1,621.81 / $1,621.81
| Facility | 50 | $1,621.81 | $1,621.81 | $1,621.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $89.13 / $131.83 / $1,819.70
| Professional | | $89.13 | $131.83 | $1,819.70 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $165.96 / $537.03 / $2,818.38
| Facility | | $165.96 | $537.03 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $53.70 / $87.10 / $138.04
| Professional | | $53.70 | $87.10 | $138.04 |