- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,202.26 / $5,888.44 / $16,595.87
| Facility | | $1,202.26 | $5,888.44 | $16,595.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $63.10 / $89.13 / $257.04
| Professional | | $63.10 | $89.13 | $257.04 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $457.09 / $457.09 / $489.78
| Professional | 50 | $457.09 | $457.09 | $489.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $77.62 / $77.62 / $79.43
| Professional | | $77.62 | $77.62 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,570.40 / $4,466.84 / $12,022.64
| Facility | | $2,570.40 | $4,466.84 | $12,022.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $74.13 / $114.82 / $229.09
| Professional | | $74.13 | $114.82 | $229.09 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $95.50 / $125.89 / $338.84
| Professional | 50 | $95.50 | $125.89 | $338.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $85.11 / $3,162.28 / $6,606.93
| Facility | | $85.11 | $3,162.28 | $6,606.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $89.13 / $125.89 / $269.15
| Professional | | $89.13 | $125.89 | $269.15 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $91.20 / $91.20 / $91.20
| Facility | | $91.20 | $91.20 | $91.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $74.13 / $104.71 / $199.53
| Professional | | $74.13 | $104.71 | $199.53 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $51.29 / $75.86 / $134.90
| Professional | | $51.29 | $75.86 | $134.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $64.57 / $97.72 / $173.78
| Professional | | $64.57 | $97.72 | $173.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $54.95 / $56.23 / $416.87
| Facility | | $54.95 | $56.23 | $416.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $676.08 / $758.58 / $758.58
| Professional | | $676.08 | $758.58 | $758.58 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $77.62 / $77.62 / $128.82
| Professional | | $77.62 | $77.62 | $128.82 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $70.79 / $104.71 / $165.96
| Facility | | $70.79 | $104.71 | $165.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $74.13 / $104.71 / $204.17
| Professional | | $74.13 | $104.71 | $204.17 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $223.87 / $223.87 / $288.40
| Professional | | $223.87 | $223.87 | $288.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $51.29 / $69.18 / $97.72
| Professional | | $51.29 | $69.18 | $97.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $549.54 / $1,548.82 / $6,456.54
| Facility | | $549.54 | $1,548.82 | $6,456.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $58.88 / $85.11 / $181.97
| Professional | | $58.88 | $85.11 | $181.97 |