- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $758.58 / $2,818.38 / $10,232.93
| Facility | | $758.58 | $2,818.38 | $10,232.93 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $2,290.87 / $2,290.87 / $2,290.87
| Facility | 50 | $2,290.87 | $2,290.87 | $2,290.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $295.12 / $707.95 / $1,621.81
| Professional | | $295.12 | $707.95 | $1,621.81 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $512.86 / $1,230.27 / $1,513.56
| Professional | 50 | $512.86 | $1,230.27 | $1,513.56 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10,964.78 / $17,378.01 / $17,378.01
| Facility | | $10,964.78 | $17,378.01 | $17,378.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $338.84 / $549.54 / $691.83
| Professional | | $338.84 | $549.54 | $691.83 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $512.86 / $1,174.90 / $1,318.26
| Professional | 50 | $512.86 | $1,174.90 | $1,318.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,495.41 / $5,495.41 / $5,495.41
| Facility | | $5,495.41 | $5,495.41 | $5,495.41 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $316.23 / $758.58 / $1,479.11
| Professional | | $316.23 | $758.58 | $1,479.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $478.63 / $1,348.96
| Professional | | $3.98 | $478.63 | $1,348.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $398.11 / $1,096.48
| Professional | | $3.02 | $398.11 | $1,096.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $269.15 / $741.31 / $1,202.26
| Professional | | $269.15 | $741.31 | $1,202.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,951.21 / $4,786.30 / $12,882.50
| Facility | | $2,951.21 | $4,786.30 | $12,882.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $309.03 / $707.95 / $1,548.82
| Professional | | $309.03 | $707.95 | $1,548.82 |