- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $251.19 / $1,412.54 / $5,495.41
| Facility | | $251.19 | $1,412.54 | $5,495.41 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $275.42 / $489.78 / $1,122.02
| Professional | | $275.42 | $489.78 | $1,122.02 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $676.08 / $1,659.59 / $1,659.59
| Professional | 50 | $676.08 | $1,659.59 | $1,659.59 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $316.23 / $812.83 / $1,513.56
| Facility | | $316.23 | $812.83 | $1,513.56 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $562.34 / $1,202.26 / $2,238.72
| Facility | 50 | $562.34 | $1,202.26 | $2,238.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $346.74 / $416.87 / $478.63
| Professional | | $346.74 | $416.87 | $478.63 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $489.78 / $616.60 / $724.44
| Professional | 50 | $489.78 | $616.60 | $724.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $363.08 / $660.69 / $891.25
| Professional | | $363.08 | $660.69 | $891.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $239.88 / $616.60 / $1,202.26
| Facility | | $239.88 | $616.60 | $1,202.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $245.47 / $407.38 / $812.83
| Professional | | $245.47 | $407.38 | $812.83 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $676.08 / $1,659.59 / $1,659.59
| Professional | 50 | $676.08 | $1,659.59 | $1,659.59 |
- 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
- $1,047.13 / $1,318.26 / $1,862.09
| Facility | | $1,047.13 | $1,318.26 | $1,862.09 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $1,584.89 / $2,089.30 / $2,754.23
| Facility | 50 | $1,584.89 | $2,089.30 | $2,754.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $323.59 / $446.68 / $501.19
| Professional | | $323.59 | $446.68 | $501.19 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $194.98 / $316.23 / $977.24
| Professional | | $194.98 | $316.23 | $977.24 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $346.74 / $4,168.69 / $4,466.84
| Facility | | $346.74 | $4,168.69 | $4,466.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $416.87 / $645.65 / $977.24
| Professional | | $416.87 | $645.65 | $977.24 |