- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $263.03 / $1,148.15 / $5,128.61
| Facility | | $263.03 | $1,148.15 | $5,128.61 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $186.21 / $5,248.07 / $5,888.44
| Facility | 50 | $186.21 | $5,248.07 | $5,888.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $64.57 / $204.17 / $691.83
| Professional | | $64.57 | $204.17 | $691.83 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $154.88 / $295.12 / $831.76
| Professional | 50 | $154.88 | $295.12 | $831.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $77.62 / $204.17 / $316.23
| Professional | | $77.62 | $204.17 | $316.23 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $77.62 / $79.43 / $331.13
| Professional | 50 | $77.62 | $79.43 | $331.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $199.53 / $199.53 / $204.17
| Facility | | $199.53 | $199.53 | $204.17 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $91.20 / $316.23 / $501.19
| Professional | | $91.20 | $316.23 | $501.19 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $602.56 / $602.56 / $602.56
| Facility | | $602.56 | $602.56 | $602.56 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $79.43 / $208.93 / $446.68
| Professional | | $79.43 | $208.93 | $446.68 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $457.09 / $457.09 / $457.09
| Professional | | $457.09 | $457.09 | $457.09 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $66.07 / $190.55 / $371.54
| Facility | | $66.07 | $190.55 | $371.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,398.83 / $2,398.83 / $7,943.28
| Facility | | $2,398.83 | $2,398.83 | $7,943.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $95.50 / $363.08 / $478.63
| Professional | | $95.50 | $363.08 | $478.63 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $331.13 / $794.33 / $1,995.26
| Facility | | $331.13 | $794.33 | $1,995.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $67.61 / $154.88 / $346.74
| Professional | | $67.61 | $154.88 | $346.74 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $56.23 / $776.25 / $776.25
| Facility | | $56.23 | $776.25 | $776.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,041.74 / $2,041.74 / $2,089.30
| Professional | | $2,041.74 | $2,041.74 | $2,089.30 |