- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $70.79 / $173.78 / $1,905.46
| Facility | | $70.79 | $173.78 | $1,905.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $44.67 / $75.86 / $181.97
| Professional | | $44.67 | $75.86 | $181.97 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $275.42 / $275.42 / $416.87
| Professional | 50 | $275.42 | $275.42 | $416.87 |
- 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
- $69.18 / $100.00 / $338.84
| Professional | | $69.18 | $100.00 | $338.84 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $104.71 / $154.88 / $501.19
| Professional | 50 | $104.71 | $154.88 | $501.19 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $134.90 / $158.49 / $251.19
| Facility | | $134.90 | $158.49 | $251.19 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $58.88 / $120.23 / $257.04
| Professional | | $58.88 | $120.23 | $257.04 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $51.29 / $91.20 / $3,548.13
| Facility | | $51.29 | $91.20 | $3,548.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $89.13 / $125.89 / $151.36
| Professional | | $89.13 | $125.89 | $151.36 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $134.90 / $186.21 / $229.09
| Professional | 50 | $134.90 | $186.21 | $229.09 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $51.29 / $95.50 / $1,778.28
| Facility | | $51.29 | $95.50 | $1,778.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $70.79 / $169.82 / $426.58
| Professional | | $70.79 | $169.82 | $426.58 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $128.82
| Professional | | $32.36 | $33.11 | $128.82 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $186.21 / $891.25 / $2,344.23
| Facility | | $186.21 | $891.25 | $2,344.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $70.79 / $257.04 / $331.13
| Professional | | $70.79 | $257.04 | $331.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $60.26 / $114.82 / $181.97
| Professional | | $60.26 | $114.82 | $181.97 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $120.23 / $1,288.25 / $1,288.25
| Facility | | $120.23 | $1,288.25 | $1,288.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $75.86 / $234.42 / $426.58
| Professional | | $75.86 | $234.42 | $426.58 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $218.78 / $218.78 / $245.47
| Professional | | $218.78 | $218.78 | $245.47 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $75.86 / $75.86 / $75.86
| Facility | | $75.86 | $75.86 | $75.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $229.09 / $457.09 / $501.19
| Professional | | $229.09 | $457.09 | $501.19 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,000.00 / $1,584.89 / $2,187.76
| Facility | | $1,000.00 | $1,584.89 | $2,187.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $64.57 / $117.49 / $389.05
| Professional | | $64.57 | $117.49 | $389.05 |