- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $724.44 / $3,715.35 / $7,943.28
| Facility | | $724.44 | $3,715.35 | $7,943.28 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $1,698.24 / $4,265.80 / $9,332.54
| Facility | 50 | $1,698.24 | $4,265.80 | $9,332.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $371.54 / $501.19 / $1,621.81
| Professional | | $371.54 | $501.19 | $1,621.81 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $724.44 / $1,318.26 / $1,862.09
| Professional | 50 | $724.44 | $1,318.26 | $1,862.09 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $302.00 / $416.87 / $724.44
| Professional | | $302.00 | $416.87 | $724.44 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $363.08 / $363.08 / $363.08
| Professional | 50 | $363.08 | $363.08 | $363.08 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,951.21 / $4,073.80 / $28,840.32
| Facility | | $2,951.21 | $4,073.80 | $28,840.32 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $229.09 / $229.09 / $295.12
| Professional | | $229.09 | $229.09 | $295.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,370.32 / $6,165.95 / $57,543.99
| Facility | | $5,370.32 | $6,165.95 | $57,543.99 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $446.68 / $660.69 / $851.14
| Professional | | $446.68 | $660.69 | $851.14 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $676.08 / $1,000.00 / $1,288.25
| Professional | 50 | $676.08 | $1,000.00 | $1,288.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $380.19 / $524.81 / $870.96
| Professional | | $380.19 | $524.81 | $870.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $575.44 / $776.25 / $1,000.00
| Professional | | $575.44 | $776.25 | $1,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $407.38 / $588.84 / $870.96
| Professional | | $407.38 | $588.84 | $870.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,949.84 / $4,073.80 / $8,128.31
| Facility | | $1,949.84 | $4,073.80 | $8,128.31 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $2,344.23 / $5,128.61 / $9,120.11
| Facility | 50 | $2,344.23 | $5,128.61 | $9,120.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $436.52 / $524.81 / $630.96
| Professional | | $436.52 | $524.81 | $630.96 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $707.95 / $758.58 / $1,230.27
| Professional | 50 | $707.95 | $758.58 | $1,230.27 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,187.76 / $3,630.78 / $14,125.38
| Facility | | $2,187.76 | $3,630.78 | $14,125.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $229.09 / $457.09 / $524.81
| Professional | | $229.09 | $457.09 | $524.81 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $398.11 / $1,659.59 / $7,244.36
| Facility | | $398.11 | $1,659.59 | $7,244.36 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $1,778.28 / $1,778.28 / $1,778.28
| Facility | 50 | $1,778.28 | $1,778.28 | $1,778.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $398.11 / $524.81 / $977.24
| Professional | | $398.11 | $524.81 | $977.24 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,445.44 / $1,819.70 / $6,606.93
| Facility | | $1,445.44 | $1,819.70 | $6,606.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $467.74 / $660.69 / $977.24
| Professional | | $467.74 | $660.69 | $977.24 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $398.11 / $407.38 / $436.52
| Facility | | $398.11 | $407.38 | $436.52 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $398.11 / $416.87 / $467.74
| Professional | | $398.11 | $416.87 | $467.74 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,737.80 / $4,073.80 / $6,918.31
| Facility | | $1,737.80 | $4,073.80 | $6,918.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $363.08 / $501.19 / $831.76
| Professional | | $363.08 | $501.19 | $831.76 |