- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,023.29 / $5,370.32 / $8,511.38
| Facility | | $1,023.29 | $5,370.32 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $181.97 / $436.52 / $1,122.02
| Professional | | $181.97 | $436.52 | $1,122.02 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $478.63 / $478.63 / $478.63
| Professional | 50 | $478.63 | $478.63 | $478.63 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,011.87 / $6,165.95 / $57,543.99
| Facility | | $5,011.87 | $6,165.95 | $57,543.99 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $457.09 / $467.74 / $812.83
| Professional | | $457.09 | $467.74 | $812.83 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $676.08 / $707.95 / $1,202.26
| Professional | 50 | $676.08 | $707.95 | $1,202.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $213.80 / $467.74 / $891.25
| Professional | | $213.80 | $467.74 | $891.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $645.65 / $645.65 / $851.14
| Professional | | $645.65 | $645.65 | $851.14 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $263.03 / $549.54 / $812.83
| Professional | | $263.03 | $549.54 | $812.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,388.44 / $3,890.45 / $8,709.64
| Facility | | $3,388.44 | $3,890.45 | $8,709.64 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $8,912.51 / $8,912.51 / $8,912.51
| Facility | 50 | $8,912.51 | $8,912.51 | $8,912.51 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $831.76 / $4,265.80 / $8,511.38
| Facility | | $831.76 | $4,265.80 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $181.97 / $416.87 / $912.01
| Professional | | $181.97 | $416.87 | $912.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $562.34 / $891.25 / $1,047.13
| Professional | | $562.34 | $891.25 | $1,047.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $190.55 / $295.12 / $537.03
| Facility | | $190.55 | $295.12 | $537.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $58.88 / $295.12 / $537.03
| Professional | | $58.88 | $295.12 | $537.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,737.80 / $3,715.35 / $6,309.57
| Facility | | $1,737.80 | $3,715.35 | $6,309.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $199.53 / $467.74 / $851.14
| Professional | | $199.53 | $467.74 | $851.14 |