- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $912.01 / $3,715.35 / $12,882.50
| Facility | | $912.01 | $3,715.35 | $12,882.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $501.19 / $645.65 / $1,047.13
| Professional | | $501.19 | $645.65 | $1,047.13 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $1,479.11 / $1,905.46 / $2,398.83
| Professional | 50 | $1,479.11 | $1,905.46 | $2,398.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $416.87 / $501.19 / $630.96
| Professional | | $416.87 | $501.19 | $630.96 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $758.58 / $758.58 / $758.58
| Professional | 50 | $758.58 | $758.58 | $758.58 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $245.47 / $389.05 / $1,584.89
| Facility | | $245.47 | $389.05 | $1,584.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $446.68 / $562.34 / $776.25
| Professional | | $446.68 | $562.34 | $776.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $436.52 / $588.84 / $831.76
| Facility | | $436.52 | $588.84 | $831.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $524.81 / $691.83 / $891.25
| Professional | | $524.81 | $691.83 | $891.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $416.87 / $478.63 / $501.19
| Facility | | $416.87 | $478.63 | $501.19 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $331.13 / $331.13 / $346.74
| Facility | | $331.13 | $331.13 | $346.74 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $501.19 / $645.65 / $1,071.52
| Professional | | $501.19 | $645.65 | $1,071.52 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $54.95 / $56.23 / $3,890.45
| Facility | | $54.95 | $56.23 | $3,890.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,801.89 / $4,265.80 / $4,265.80
| Professional | | $3,801.89 | $4,265.80 | $4,265.80 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $512.86 / $794.33 / $4,677.35
| Facility | | $512.86 | $794.33 | $4,677.35 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $501.19 / $676.08 / $1,122.02
| Professional | | $501.19 | $676.08 | $1,122.02 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $1,479.11 / $1,479.11 / $2,398.83
| Professional | 50 | $1,479.11 | $1,479.11 | $2,398.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $123.03 / $1,096.48
| Professional | | $32.36 | $123.03 | $1,096.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $446.68 / $794.33 / $1,071.52
| Professional | | $446.68 | $794.33 | $1,071.52 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $489.78 / $660.69 / $1,071.52
| Facility | | $489.78 | $660.69 | $1,071.52 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $501.19 / $660.69 / $1,071.52
| Professional | | $501.19 | $660.69 | $1,071.52 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $436.52 / $1,412.54 / $3,548.13
| Facility | | $436.52 | $1,412.54 | $3,548.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $407.38 / $549.54 / $831.76
| Professional | | $407.38 | $549.54 | $831.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $501.19 / $524.81 / $524.81
| Professional | | $501.19 | $524.81 | $524.81 |