- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $489.78 / $2,344.23 / $8,317.64
| Facility | | $489.78 | $2,344.23 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $562.34 / $933.25 / $1,023.29
| Facility | 50 | $562.34 | $933.25 | $1,023.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $257.04 / $346.74 / $758.58
| Professional | | $257.04 | $346.74 | $758.58 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $436.52 / $812.83 / $1,380.38
| Professional | 50 | $436.52 | $812.83 | $1,380.38 |
- Facility/Professional
- Professional
- Modifier
- 54
- Typical Low / Median / Typical High
- $239.88 / $363.08 / $870.96
| Professional | 54 | $239.88 | $363.08 | $870.96 |
- Facility/Professional
- Professional
- Modifier
- 55
- Typical Low / Median / Typical High
- $63.10 / $63.10 / $389.05
| Professional | 55 | $63.10 | $63.10 | $389.05 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $223.87 / $363.08 / $588.84
| Professional | | $223.87 | $363.08 | $588.84 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $741.31 / $812.83 / $977.24
| Professional | 50 | $741.31 | $812.83 | $977.24 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $331.13 / $1,995.26 / $11,220.18
| Facility | | $331.13 | $1,995.26 | $11,220.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $257.04 / $288.40 / $346.74
| Professional | | $257.04 | $288.40 | $346.74 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $295.12 / $346.74 / $12,589.25
| Facility | | $295.12 | $346.74 | $12,589.25 |
- Facility/Professional
- Facility
- Modifier
- 54
- Typical Low / Median / Typical High
- $354.81 / $354.81 / $354.81
| Facility | 54 | $354.81 | $354.81 | $354.81 |
- Facility/Professional
- Facility
- Modifier
- 55
- Typical Low / Median / Typical High
- $75.86 / $75.86 / $75.86
| Facility | 55 | $75.86 | $75.86 | $75.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $229.09 / $346.74 / $691.83
| Professional | | $229.09 | $346.74 | $691.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,089.30 / $3,090.30 / $6,309.57
| Facility | | $2,089.30 | $3,090.30 | $6,309.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $144.54 / $239.88 / $380.19
| Professional | | $144.54 | $239.88 | $380.19 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $380.19
| Professional | | $32.36 | $33.11 | $380.19 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $457.09 / $2,238.72 / $5,011.87
| Facility | | $457.09 | $2,238.72 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $218.78 / $302.00 / $537.03
| Professional | | $218.78 | $302.00 | $537.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $234.42 / $251.19 / $346.74
| Professional | | $234.42 | $251.19 | $346.74 |