- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $588.84 / $2,691.53 / $8,317.64
| Facility | | $588.84 | $2,691.53 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $44.67 / $72.44 / $173.78
| Professional | | $44.67 | $72.44 | $173.78 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $109.65 / $218.78 / $275.42
| Professional | 50 | $109.65 | $218.78 | $275.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $50.12 / $50.12 / $50.12
| Professional | | $50.12 | $50.12 | $50.12 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $75.86 / $75.86 / $75.86
| Professional | 50 | $75.86 | $75.86 | $75.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $52.48 / $52.48 / $52.48
| Professional | | $52.48 | $52.48 | $52.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,344.23 / $2,570.40 / $57,543.99
| Facility | | $2,344.23 | $2,570.40 | $57,543.99 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $50.12 / $52.48 / $173.78
| Professional | | $50.12 | $52.48 | $173.78 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $75.86 / $77.62 / $263.03
| Professional | 50 | $75.86 | $77.62 | $263.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $354.81 / $354.81 / $354.81
| Facility | | $354.81 | $354.81 | $354.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $42.66 / $77.62 / $165.96
| Professional | | $42.66 | $77.62 | $165.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $63.10 / $63.10 / $87.10
| Professional | | $63.10 | $63.10 | $87.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $45.71 / $69.18 / $120.23
| Professional | | $45.71 | $69.18 | $120.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $204.17 / $398.11 / $1,995.26
| Facility | | $204.17 | $398.11 | $1,995.26 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $1,995.26 / $1,995.26 / $2,570.40
| Facility | 50 | $1,995.26 | $1,995.26 | $2,570.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $57.54 / $61.66 / $79.43
| Professional | | $57.54 | $61.66 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $93.33 / $93.33 / $147.91
| Professional | 50 | $93.33 | $93.33 | $147.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $52.48 / $52.48 / $52.48
| Professional | | $52.48 | $52.48 | $52.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $537.03 / $1,905.46 / $6,606.93
| Facility | | $537.03 | $1,905.46 | $6,606.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $45.71 / $67.61 / $117.49
| Professional | | $45.71 | $67.61 | $117.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $30.20 / $66.07 / $229.09
| Professional | | $30.20 | $66.07 | $229.09 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $45.71 / $63.10 / $81.28
| Facility | | $45.71 | $63.10 | $81.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $27.54 / $50.12 / $75.86
| Professional | | $27.54 | $50.12 | $75.86 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $363.08 / $758.58 / $3,890.45
| Facility | | $363.08 | $758.58 | $3,890.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $45.71 / $69.18 / $120.23
| Professional | | $45.71 | $69.18 | $120.23 |