- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $426.58 / $1,318.26 / $8,511.38
| Facility | | $426.58 | $1,318.26 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $2,951.21 / $2,951.21 / $12,882.50
| Facility | 50 | $2,951.21 | $2,951.21 | $12,882.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $281.84 / $660.69 / $1,584.89
| Professional | | $281.84 | $660.69 | $1,584.89 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $512.86 / $1,047.13 / $4,265.80
| Professional | 50 | $512.86 | $1,047.13 | $4,265.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $281.84 / $281.84 / $281.84
| Professional | | $281.84 | $281.84 | $281.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,290.87 / $3,801.89 / $8,511.38
| Facility | | $2,290.87 | $3,801.89 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $331.13 / $416.87 / $562.34
| Professional | | $331.13 | $416.87 | $562.34 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $489.78 / $616.60 / $851.14
| Professional | 50 | $489.78 | $616.60 | $851.14 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $275.42 / $380.19 / $489.78
| Facility | | $275.42 | $380.19 | $489.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $275.42 / $380.19 / $467.74
| Professional | | $275.42 | $380.19 | $467.74 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $512.86 / $512.86 / $1,862.09
| Facility | | $512.86 | $512.86 | $1,862.09 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $363.08 / $933.25 / $5,011.87
| Professional | | $363.08 | $933.25 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $588.84
| Professional | | $32.36 | $33.11 | $588.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $977.24 / $7,079.46 / $19,952.62
| Facility | | $977.24 | $7,079.46 | $19,952.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $323.59 / $660.69 / $1,513.56
| Professional | | $323.59 | $660.69 | $1,513.56 |