- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $446.68 / $2,089.30 / $6,918.31
| Facility | | $446.68 | $2,089.30 | $6,918.31 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $43.65 / $10,000.00 / $17,782.79
| Facility | 50 | $43.65 | $10,000.00 | $17,782.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $302.00 / $467.74 / $1,258.93
| Professional | | $302.00 | $467.74 | $1,258.93 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $933.25 / $954.99 / $2,818.38
| Professional | 50 | $933.25 | $954.99 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $251.19 / $331.13 / $416.87
| Professional | | $251.19 | $331.13 | $416.87 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $354.81 / $354.81 / $478.63
| Professional | 50 | $354.81 | $354.81 | $478.63 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $177.83 / $281.84 / $1,096.48
| Facility | | $177.83 | $281.84 | $1,096.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $275.42 / $354.81 / $512.86
| Professional | | $275.42 | $354.81 | $512.86 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $275.42 / $588.84 / $1,000.00
| Facility | | $275.42 | $588.84 | $1,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $323.59 / $426.58 / $602.56
| Professional | | $323.59 | $426.58 | $602.56 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $251.19 / $478.63 / $478.63
| Facility | | $251.19 | $478.63 | $478.63 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $213.80 / $213.80 / $218.78
| Facility | | $213.80 | $213.80 | $218.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $316.23 / $436.52 / $1,698.24
| Professional | | $316.23 | $436.52 | $1,698.24 |
- 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
- $4,897.79 / $4,897.79 / $5,623.41
| Professional | | $4,897.79 | $4,897.79 | $5,623.41 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $316.23 / $891.25 / $3,548.13
| Facility | | $316.23 | $891.25 | $3,548.13 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $43.65 / $10,000.00 / $17,782.79
| Facility | 50 | $43.65 | $10,000.00 | $17,782.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $309.03 / $457.09 / $1,230.27
| Professional | | $309.03 | $457.09 | $1,230.27 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $933.25 / $954.99 / $2,818.38
| Professional | 50 | $933.25 | $954.99 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $831.76
| Professional | | $32.36 | $33.11 | $831.76 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,137.96 / $2,137.96 / $2,238.72
| Facility | | $2,137.96 | $2,137.96 | $2,238.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $269.15 / $478.63 / $724.44
| Professional | | $269.15 | $478.63 | $724.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $302.00 / $478.63 / $1,445.44
| Facility | | $302.00 | $478.63 | $1,445.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $316.23 / $436.52 / $1,659.59
| Professional | | $316.23 | $436.52 | $1,659.59 |
- 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
- $263.03 / $426.58 / $1,230.27
| Professional | | $263.03 | $426.58 | $1,230.27 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $331.13 / $346.74 / $346.74
| Professional | | $331.13 | $346.74 | $346.74 |