- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $575.44 / $2,454.71 / $6,918.31
| Facility | | $575.44 | $2,454.71 | $6,918.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $53.70 / $1,122.02 / $2,137.96
| Professional | | $53.70 | $1,122.02 | $2,137.96 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $6,025.60 / $6,025.60 / $6,025.60
| Professional | 50 | $6,025.60 | $6,025.60 | $6,025.60 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,202.26 / $1,258.93 / $1,412.54
| Professional | | $1,202.26 | $1,258.93 | $1,412.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $812.83 / $1,348.96 / $2,754.23
| Facility | | $812.83 | $1,348.96 | $2,754.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $35.48 / $912.01 / $1,548.82
| Professional | | $35.48 | $912.01 | $1,548.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,258.93 / $1,698.24 / $2,089.30
| Professional | | $1,258.93 | $1,698.24 | $2,089.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $35.48 / $691.83 / $1,230.27
| Facility | | $35.48 | $691.83 | $1,230.27 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $52.48 / $1,174.90 / $2,238.72
| Professional | | $52.48 | $1,174.90 | $2,238.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $54.95 / $56.23 / $3,890.45
| Facility | | $54.95 | $56.23 | $3,890.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8,912.51 / $10,715.19 / $10,715.19
| Professional | | $8,912.51 | $10,715.19 | $10,715.19 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $47.86 / $1,412.54 / $3,890.45
| Facility | | $47.86 | $1,412.54 | $3,890.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $53.70 / $1,122.02 / $2,187.76
| Professional | | $53.70 | $1,122.02 | $2,187.76 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $6,025.60 / $6,025.60 / $6,025.60
| Professional | 50 | $6,025.60 | $6,025.60 | $6,025.60 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $1,122.02
| Professional | | $32.36 | $33.11 | $1,122.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $37.15 / $954.99 / $2,511.89
| Professional | | $37.15 | $954.99 | $2,511.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $43.65 / $1,096.48 / $2,089.30
| Facility | | $43.65 | $1,096.48 | $2,089.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $50.12 / $1,174.90 / $2,238.72
| Professional | | $50.12 | $1,174.90 | $2,238.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $724.44 / $1,995.26 / $4,073.80
| Facility | | $724.44 | $1,995.26 | $4,073.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $50.12 / $645.65 / $1,819.70
| Professional | | $50.12 | $645.65 | $1,819.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,202.26 / $1,258.93 / $1,258.93
| Professional | | $1,202.26 | $1,258.93 | $1,258.93 |