- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $630.96 / $2,691.53 / $7,079.46
| Facility | | $630.96 | $2,691.53 | $7,079.46 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $1,047.13 / $3,235.94 / $4,570.88
| Facility | 50 | $1,047.13 | $3,235.94 | $4,570.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $64.57 / $194.98 / $575.44
| Professional | | $64.57 | $194.98 | $575.44 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $97.72 / $223.87 / $912.01
| Professional | 50 | $97.72 | $223.87 | $912.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $74.13 / $125.89 / $478.63
| Professional | | $74.13 | $125.89 | $478.63 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $95.50 / $186.21 / $776.25
| Professional | 50 | $95.50 | $186.21 | $776.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,513.56 / $1,513.56 / $7,943.28
| Facility | | $1,513.56 | $1,513.56 | $7,943.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $79.43 / $117.49 / $199.53
| Professional | | $79.43 | $117.49 | $199.53 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $120.23 / $173.78 / $295.12
| Professional | 50 | $120.23 | $173.78 | $295.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $77.62 / $93.33 / $131.83
| Facility | | $77.62 | $93.33 | $131.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $218.78 / $281.84 / $323.59
| Professional | | $218.78 | $281.84 | $323.59 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,511.89 / $2,511.89 / $2,511.89
| Facility | | $2,511.89 | $2,511.89 | $2,511.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $85.11 / $199.53 / $501.19
| Professional | | $85.11 | $199.53 | $501.19 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $67.61 / $295.12 / $1,348.96
| Professional | | $67.61 | $295.12 | $1,348.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,168.69 / $5,888.44 / $7,943.28
| Facility | | $4,168.69 | $5,888.44 | $7,943.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $95.50 / $354.81 / $446.68
| Professional | | $95.50 | $354.81 | $446.68 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $213.80 / $1,348.96 / $2,344.23
| Facility | | $213.80 | $1,348.96 | $2,344.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $70.79 / $165.96 / $389.05
| Professional | | $70.79 | $165.96 | $389.05 |