- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $100.00 / $331.13 / $1,905.46
| Facility | | $100.00 | $331.13 | $1,905.46 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $954.99 / $954.99 / $954.99
| Facility | 50 | $954.99 | $954.99 | $954.99 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $100.00 / $158.49 / $416.87
| Professional | | $100.00 | $158.49 | $416.87 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $616.60 / $645.65 / $1,621.81
| Professional | 50 | $616.60 | $645.65 | $1,621.81 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,584.89 / $3,090.30 / $5,754.40
| Facility | | $1,584.89 | $3,090.30 | $5,754.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $144.54 / $218.78 / $512.86
| Professional | | $144.54 | $218.78 | $512.86 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $229.09 / $331.13 / $776.25
| Professional | 50 | $229.09 | $331.13 | $776.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $426.58 / $501.19 / $794.33
| Facility | | $426.58 | $501.19 | $794.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $165.96 / $380.19 / $724.44
| Professional | | $165.96 | $380.19 | $724.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $107.15 / $218.78 / $3,311.31
| Facility | | $107.15 | $218.78 | $3,311.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $194.98 / $295.12 / $436.52
| Professional | | $194.98 | $295.12 | $436.52 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $295.12 / $436.52 / $660.69
| Professional | 50 | $295.12 | $436.52 | $660.69 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $117.49 / $223.87 / $3,630.78
| Facility | | $117.49 | $223.87 | $3,630.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $186.21 / $338.84 / $1,318.26
| Professional | | $186.21 | $338.84 | $1,318.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $70.79
| Professional | | $32.36 | $33.11 | $70.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $831.76 / $2,951.21 / $3,235.94
| Facility | | $831.76 | $2,951.21 | $3,235.94 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $199.53 / $363.08 / $676.08
| Professional | | $199.53 | $363.08 | $676.08 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $177.83 / $309.03 / $524.81
| Professional | | $177.83 | $309.03 | $524.81 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $331.13 / $331.13 / $660.69
| Facility | | $331.13 | $331.13 | $660.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $204.17 / $501.19 / $1,318.26
| Professional | | $204.17 | $501.19 | $1,318.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $371.54 / $371.54 / $575.44
| Professional | | $371.54 | $371.54 | $575.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $512.86 / $630.96 / $933.25
| Professional | | $512.86 | $630.96 | $933.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,949.84 / $2,754.23 / $5,011.87
| Facility | | $1,949.84 | $2,754.23 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $125.89 / $229.09 / $588.84
| Professional | | $125.89 | $229.09 | $588.84 |