- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $776.25 / $4,570.88 / $11,220.18
| Facility | | $776.25 | $4,570.88 | $11,220.18 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $9,772.37 / $9,772.37 / $9,772.37
| Facility | 50 | $9,772.37 | $9,772.37 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $501.19 / $707.95 / $1,995.26
| Professional | | $501.19 | $707.95 | $1,995.26 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $616.60 / $616.60 / $741.31
| Professional | 50 | $616.60 | $616.60 | $741.31 |
- Facility/Professional
- Professional
- Modifier
- 54
- Typical Low / Median / Typical High
- $398.11 / $537.03 / $1,513.56
| Professional | 54 | $398.11 | $537.03 | $1,513.56 |
- Facility/Professional
- Professional
- Modifier
- 55
- Typical Low / Median / Typical High
- $6.76 / $107.15 / $831.76
| Professional | 55 | $6.76 | $107.15 | $831.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $87.10 / $446.68 / $676.08
| Professional | | $87.10 | $446.68 | $676.08 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,467.37 / $7,762.47 / $10,471.29
| Facility | | $3,467.37 | $7,762.47 | $10,471.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $616.60 / $758.58 / $1,148.15
| Professional | | $616.60 | $758.58 | $1,148.15 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $912.01 / $1,148.15 / $1,737.80
| Professional | 50 | $912.01 | $1,148.15 | $1,737.80 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $489.78 / $537.03 / $691.83
| Facility | | $489.78 | $537.03 | $691.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $489.78 / $537.03 / $660.69
| Professional | | $489.78 | $537.03 | $660.69 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $602.56 / $6,165.95 / $6,165.95
| Facility | | $602.56 | $6,165.95 | $6,165.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $501.19 / $741.31 / $1,380.38
| Professional | | $501.19 | $741.31 | $1,380.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,445.44 / $5,623.41 / $14,125.38
| Facility | | $1,445.44 | $5,623.41 | $14,125.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $524.81 / $707.95 / $1,148.15
| Professional | | $524.81 | $707.95 | $1,148.15 |