- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,365.16 / $5,495.41 / $12,589.25
| Facility | | $4,365.16 | $5,495.41 | $12,589.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $758.58 / $1,071.52 / $2,691.53
| Professional | | $758.58 | $1,071.52 | $2,691.53 |
- Facility/Professional
- Professional
- Modifier
- 54
- Typical Low / Median / Typical High
- $575.44 / $616.60 / $724.44
| Professional | 54 | $575.44 | $616.60 | $724.44 |
- Facility/Professional
- Professional
- Modifier
- 55
- Typical Low / Median / Typical High
- $173.78 / $173.78 / $173.78
| Professional | 55 | $173.78 | $173.78 | $173.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,548.82 / $3,019.95 / $6,025.60
| Facility | | $1,548.82 | $3,019.95 | $6,025.60 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $2,238.72 / $4,466.84 / $9,120.11
| Facility | 50 | $2,238.72 | $4,466.84 | $9,120.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,202.26 / $1,412.54 / $1,479.11
| Professional | | $1,202.26 | $1,412.54 | $1,479.11 |
- Facility/Professional
- Professional
- Modifier
- 54
- Typical Low / Median / Typical High
- $912.01 / $1,122.02 / $1,174.90
| Professional | 54 | $912.01 | $1,122.02 | $1,174.90 |
- Facility/Professional
- Professional
- Modifier
- 55
- Typical Low / Median / Typical High
- $229.09 / $281.84 / $295.12
| Professional | 55 | $229.09 | $281.84 | $295.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $588.84 / $1,071.52 / $1,412.54
| Professional | | $588.84 | $1,071.52 | $1,412.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $741.31 / $1,659.59 / $8,511.38
| Facility | | $741.31 | $1,659.59 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $691.83 / $1,096.48 / $1,737.80
| Professional | | $691.83 | $1,096.48 | $1,737.80 |
- Facility/Professional
- Professional
- Modifier
- 54
- Typical Low / Median / Typical High
- $575.44 / $616.60 / $724.44
| Professional | 54 | $575.44 | $616.60 | $724.44 |
- Facility/Professional
- Professional
- Modifier
- 55
- Typical Low / Median / Typical High
- $173.78 / $173.78 / $173.78
| Professional | 55 | $173.78 | $173.78 | $173.78 |
- 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
- $4,073.80 / $5,248.07 / $7,585.78
| Facility | | $4,073.80 | $5,248.07 | $7,585.78 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $6,309.57 / $8,709.64 / $11,220.18
| Facility | 50 | $6,309.57 | $8,709.64 | $11,220.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,230.27 / $1,479.11 / $1,548.82
| Professional | | $1,230.27 | $1,479.11 | $1,548.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $588.84 / $1,202.26 / $2,884.03
| Professional | | $588.84 | $1,202.26 | $2,884.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,148.15 / $12,302.69 / $12,302.69
| Facility | | $1,148.15 | $12,302.69 | $12,302.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $851.14 / $1,148.15 / $1,659.59
| Professional | | $851.14 | $1,148.15 | $1,659.59 |