- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $512.86 / $588.84 / $1,659.59
| Facility | | $512.86 | $588.84 | $1,659.59 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $3,715.35 / $4,466.84 / $4,466.84
| Facility | 50 | $3,715.35 | $4,466.84 | $4,466.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $316.23 / $588.84 / $1,905.46
| Professional | | $316.23 | $588.84 | $1,905.46 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $933.25 / $1,412.54 / $1,513.56
| Professional | 50 | $933.25 | $1,412.54 | $1,513.56 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,584.89 / $3,090.30 / $5,754.40
| Facility | | $1,584.89 | $3,090.30 | $5,754.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $338.84 / $588.84 / $2,290.87
| Professional | | $338.84 | $588.84 | $2,290.87 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $501.19 / $870.96 / $3,467.37
| Professional | 50 | $501.19 | $870.96 | $3,467.37 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $380.19 / $380.19 / $380.19
| Facility | | $380.19 | $380.19 | $380.19 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $426.58 / $426.58 / $426.58
| Professional | | $426.58 | $426.58 | $426.58 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $891.25 / $1,047.13 / $1,698.24
| Facility | | $891.25 | $1,047.13 | $1,698.24 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $426.58 / $851.14 / $1,621.81
| Professional | | $426.58 | $851.14 | $1,621.81 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $331.13 / $691.83 / $3,548.13
| Facility | | $331.13 | $691.83 | $3,548.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $588.84 / $812.83 / $1,000.00
| Professional | | $588.84 | $812.83 | $1,000.00 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $891.25 / $1,202.26 / $1,479.11
| Professional | 50 | $891.25 | $1,202.26 | $1,479.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $331.13 / $851.14 / $3,981.07
| Facility | | $331.13 | $851.14 | $3,981.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $398.11 / $1,318.26 / $5,248.07
| Professional | | $398.11 | $1,318.26 | $5,248.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $1,380.38
| Professional | | $32.36 | $33.11 | $1,380.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,819.70 / $2,951.21 / $3,235.94
| Facility | | $1,819.70 | $2,951.21 | $3,235.94 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $467.74 / $1,348.96 / $3,548.13
| Professional | | $467.74 | $1,348.96 | $3,548.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $398.11 / $758.58 / $1,202.26
| Professional | | $398.11 | $758.58 | $1,202.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $776.25 / $3,890.45 / $3,890.45
| Facility | | $776.25 | $3,890.45 | $3,890.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $549.54 / $1,548.82 / $5,370.32
| Professional | | $549.54 | $1,548.82 | $5,370.32 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,412.54 / $1,412.54 / $1,584.89
| Professional | | $1,412.54 | $1,412.54 | $1,584.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $562.34 / $562.34 / $562.34
| Facility | | $562.34 | $562.34 | $562.34 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,548.82 / $2,951.21 / $3,311.31
| Professional | | $1,548.82 | $2,951.21 | $3,311.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,949.84 / $2,754.23 / $5,011.87
| Facility | | $1,949.84 | $2,754.23 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $95.50 / $1,047.13 / $2,570.40
| Professional | | $95.50 | $1,047.13 | $2,570.40 |