- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $933.25 / $4,073.80 / $8,709.64
| Facility | | $933.25 | $4,073.80 | $8,709.64 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $7,943.28 / $7,943.28 / $7,943.28
| Facility | 50 | $7,943.28 | $7,943.28 | $7,943.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $407.38 / $758.58 / $3,388.44
| Professional | | $407.38 | $758.58 | $3,388.44 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $741.31 / $2,187.76 / $3,090.30
| Professional | 50 | $741.31 | $2,187.76 | $3,090.30 |
- Facility/Professional
- Professional
- Modifier
- 54
- Typical Low / Median / Typical High
- $398.11 / $537.03 / $1,230.27
| Professional | 54 | $398.11 | $537.03 | $1,230.27 |
- Facility/Professional
- Professional
- Modifier
- 55
- Typical Low / Median / Typical High
- $75.86 / $102.33 / $831.76
| Professional | 55 | $75.86 | $102.33 | $831.76 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,467.37 / $6,456.54 / $10,964.78
| Facility | | $3,467.37 | $6,456.54 | $10,964.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $562.34 / $724.44 / $1,071.52
| Professional | | $562.34 | $724.44 | $1,071.52 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $758.58 / $851.14 / $954.99
| Professional | 50 | $758.58 | $851.14 | $954.99 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $562.34 / $831.76 / $1,258.93
| Professional | | $562.34 | $831.76 | $1,258.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $660.69 / $676.08 / $3,311.31
| Professional | | $660.69 | $676.08 | $3,311.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $478.63 / $524.81 / $891.25
| Professional | | $478.63 | $524.81 | $891.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,454.71 / $5,128.61 / $11,481.54
| Facility | | $2,454.71 | $5,128.61 | $11,481.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $630.96 / $851.14 / $1,318.26
| Professional | | $630.96 | $851.14 | $1,318.26 |
- Facility/Professional
- Professional
- Modifier
- 55
- Typical Low / Median / Typical High
- $199.53 / $199.53 / $199.53
| Professional | 55 | $199.53 | $199.53 | $199.53 |