- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $512.86 / $5,248.07 / $9,772.37
| Facility | | $512.86 | $5,248.07 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $281.84 / $389.05 / $831.76
| Professional | | $281.84 | $389.05 | $831.76 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $467.74 / $724.44 / $1,698.24
| Professional | 50 | $467.74 | $724.44 | $1,698.24 |
- Facility/Professional
- Professional
- Modifier
- 54
- Typical Low / Median / Typical High
- $338.84 / $363.08 / $436.52
| Professional | 54 | $338.84 | $363.08 | $436.52 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $245.47 / $281.84 / $316.23
| Professional | | $245.47 | $281.84 | $316.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $602.56 / $1,096.48 / $2,137.96
| Facility | | $602.56 | $1,096.48 | $2,137.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $275.42 / $354.81 / $512.86
| Professional | | $275.42 | $354.81 | $512.86 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $478.63 / $478.63 / $501.19
| Facility | | $478.63 | $478.63 | $501.19 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $269.15 / $398.11 / $691.83
| Professional | | $269.15 | $398.11 | $691.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $288.40 / $389.05 / $812.83
| Facility | | $288.40 | $389.05 | $812.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $32.36 / $33.11
| Professional | | $32.36 | $32.36 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $436.52 / $3,090.30 / $7,762.47
| Facility | | $436.52 | $3,090.30 | $7,762.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $251.19 / $331.13 / $537.03
| Professional | | $251.19 | $331.13 | $537.03 |