- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $97.72 / $2,630.27 / $7,762.47
| Facility | | $97.72 | $2,630.27 | $7,762.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $64.57 / $89.13 / $204.17
| Professional | | $64.57 | $89.13 | $204.17 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $371.54 / $380.19 / $380.19
| Professional | 50 | $371.54 | $380.19 | $380.19 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,819.70 / $3,630.78 / $5,011.87
| Facility | | $1,819.70 | $3,630.78 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $77.62 / $97.72 / $213.80
| Professional | | $77.62 | $97.72 | $213.80 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $117.49 / $144.54 / $323.59
| Professional | 50 | $117.49 | $144.54 | $323.59 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $93.33 / $1,258.93 / $4,073.80
| Facility | | $93.33 | $1,258.93 | $4,073.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $93.33 / $93.33 / $125.89
| Professional | | $93.33 | $93.33 | $125.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $34.67 / $114.82 / $53,703.18
| Facility | | $34.67 | $114.82 | $53,703.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $75.86 / $128.82 / $354.81
| Professional | | $75.86 | $128.82 | $354.81 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $44.67 / $72.44 / $181.97
| Facility | | $44.67 | $72.44 | $181.97 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $97.72 / $144.54 / $199.53
| Professional | | $97.72 | $144.54 | $199.53 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $85.11 / $85.11 / $85.11
| Facility | | $85.11 | $85.11 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $72.44 / $117.49 / $194.98
| Professional | | $72.44 | $117.49 | $194.98 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $128.82 / $128.82 / $128.82
| Professional | 50 | $128.82 | $128.82 | $128.82 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $75.86 / $50,118.72 / $75,857.76
| Facility | | $75.86 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $102.33 / $144.54 / $204.17
| Professional | | $102.33 | $144.54 | $204.17 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $891.25 / $2,398.83 / $4,897.79
| Facility | | $891.25 | $2,398.83 | $4,897.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $63.10 / $112.20 / $346.74
| Professional | | $63.10 | $112.20 | $346.74 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $54.95 / $79.43 / $218.78
| Facility | | $54.95 | $79.43 | $218.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $74.13 / $107.15 / $218.78
| Professional | | $74.13 | $107.15 | $218.78 |