- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,951.21 / $7,585.78 / $18,197.01
| Facility | | $2,951.21 | $7,585.78 | $18,197.01 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $5,128.61 / $5,128.61 / $30,199.52
| Facility | 50 | $5,128.61 | $5,128.61 | $30,199.52 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $758.58 / $1,148.15 / $3,388.44
| Professional | | $758.58 | $1,148.15 | $3,388.44 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $1,230.27 / $1,230.27 / $6,918.31
| Professional | 50 | $1,230.27 | $1,230.27 | $6,918.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,570.88 / $7,943.28 / $15,848.93
| Facility | | $4,570.88 | $7,943.28 | $15,848.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $954.99 / $1,348.96 / $3,019.95
| Professional | | $954.99 | $1,348.96 | $3,019.95 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $1,288.25 / $1,698.24 / $2,754.23
| Professional | 50 | $1,288.25 | $1,698.24 | $2,754.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $85.11 / $5,370.32 / $10,471.29
| Facility | | $85.11 | $5,370.32 | $10,471.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $851.14 / $1,174.90 / $2,884.03
| Professional | | $851.14 | $1,174.90 | $2,884.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $575.44 / $2,238.72 / $3,090.30
| Facility | | $575.44 | $2,238.72 | $3,090.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $891.25 / $1,202.26 / $2,570.40
| Professional | | $891.25 | $1,202.26 | $2,570.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $501.19 / $1,148.15 / $1,548.82
| Professional | | $501.19 | $1,148.15 | $1,548.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $870.96 / $1,148.15 / $2,290.87
| Professional | | $870.96 | $1,148.15 | $2,290.87 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9,772.37 / $45,708.82 / $45,708.82
| Facility | | $9,772.37 | $45,708.82 | $45,708.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7,413.10 / $8,511.38 / $8,511.38
| Professional | | $7,413.10 | $8,511.38 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,445.44 / $1,445.44 / $1,445.44
| Professional | | $1,445.44 | $1,445.44 | $1,445.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $977.24 / $1,230.27 / $1,819.70
| Facility | | $977.24 | $1,230.27 | $1,819.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $891.25 / $1,230.27 / $2,630.27
| Professional | | $891.25 | $1,230.27 | $2,630.27 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,235.94 / $3,235.94 / $3,235.94
| Professional | | $3,235.94 | $3,235.94 | $3,235.94 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $630.96 / $891.25 / $1,148.15
| Professional | | $630.96 | $891.25 | $1,148.15 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,786.30 / $9,549.93 / $20,417.38
| Facility | | $4,786.30 | $9,549.93 | $20,417.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $758.58 / $1,000.00 / $2,398.83
| Professional | | $758.58 | $1,000.00 | $2,398.83 |